Clsd tx/clavicular fx without manip 23500 at WellSpan Waynesboro Hospital
501 E. Main St., Waynesboro, PA · Wellspan · · NPI 1821091059
$450.40
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$563.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$74.03 with UPMC_Medicare vs $981.61 with Highmark — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $74.03 | ↓ -84% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $74.03 | ↓ -84% |
| UPMC_Medicaid | All_Plans | $74.38 | ↓ -83% |
| Geisinger_Medicaid | All_Plans | $88.13 | ↓ -80% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $88.13 | ↓ -80% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $88.13 | ↓ -80% |
| Amerihealth_Caritas_Medicaid | All_Plans | $100.11 | ↓ -78% |
| PA_Health_&_Wellness_Medicare | All_Plans | $255.28 | ↓ -43% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $255.76 | ↓ -43% |
| United_Medicaid | Community_Plan_For_Kids | $255.76 | ↓ -43% |
| Highmark | All_Other_Plans | $255.76 | ↓ -43% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $255.76 | ↓ -43% |
| Highmark_Medicare | All_Plans | $258.32 | ↓ -43% |
| Aetna_Medicare | All_Plans | $263.43 | ↓ -42% |
| Aetna_Advantra_Medicare | All_Plans | $263.43 | ↓ -42% |
| Devoted_Medicare | All_Plans | $268.55 | ↓ -40% |
| United_Medicare | ISNP_DSNP_Plans | $268.55 | ↓ -40% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $269.70 | ↓ -40% |
| Amerihealth_Medicare | All_Plans | $269.83 | ↓ -40% |
| Geisinger_Gold_Medicare | All_Plans | $319.70 | ↓ -29% |
| UPMC | UPMC_For_Kids | $337.80 | ↓ -25% |
| Aetna | All_Plans | $378.34 | ↓ -16% |
| Highmark | Higmark_Healthy_Kids | $391.31 | ↓ -13% |
| Cigna | All_Plans | $412.62 | ↓ -8% |
| Geisinger | All_Plans | $416.62 | ↓ -8% |
| Health_Partners_Medicaid | Kidz_Partners | $422.00 | ↓ -6% |
| Cigna | PPO_Plan | $433.23 | ↓ -4% |
| WellSpan_Capital_Blue_Cross | All_Plans | $506.70 | ↑ +13% |
| First_Health_Network | All_Plans | $534.85 | ↑ +19% |
| United_Healthcare | All_Plans | $537.10 | ↑ +19% |
| Highmark | My_Direct_Blue | $862.73 | ↑ +92% |
| Highmark | Shared_Cost_Blue_PPO | $862.73 | ↑ +92% |
| Aetna_Better_Health_Kids | All_Plans | $869.58 | ↑ +93% |
| Health_Partners_Medicaid | All_Other_Plans | $971.24 | ↑ +116% |
| Highmark | Choice_Blue_PPO | $981.61 | ↑ +118% |
| Highmark | Performance_Blue | $981.61 | ↑ +118% |
| Highmark | Blue_Cross_High_Performance_Network | $981.61 | ↑ +118% |
Visitor-reported prices
Comments
Clsd tx/clavicular fx without manip 23500 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $1,615.20 | $74.03 – $2,422.80 |
| UPMC Carlisle | Carlisle | $819.60 | $89.53 – $1,161.10 |
| UPMC Cole | Coudersport | $1,266.00 | $52.95 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $819.60 | $89.53 – $1,714.22 |
| UPMC Hanover | Hanover | $819.60 | $89.53 – $1,016.56 |
| UPMC Kane | Kane | $244.80 | $77.55 – $961.48 |
| UPMC Lititz | Lititz | $819.60 | $89.53 – $1,016.56 |
| UPMC Memorial | York | $819.60 | $89.53 – $1,016.56 |