Established Patient Office Visit (level 3) at WellSpan Waynesboro Hospital
501 E. Main St., Waynesboro, PA · Wellspan · · NPI 1821091059
$421.60
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.
$527.00
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.
$42.00 with UPMC_Medicare vs $527.34 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 | $42.00 | ↓ -90% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $42.00 | ↓ -90% |
| UPMC_Medicaid | All_Plans | $42.20 | ↓ -90% |
| Geisinger_Medicaid | All_Plans | $50.00 | ↓ -88% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $50.00 | ↓ -88% |
| Amerihealth_Caritas_Medicaid | All_Plans | $56.80 | ↓ -87% |
| PA_Health_&_Wellness_Medicare | All_Plans | $137.14 | ↓ -67% |
| Highmark | All_Other_Plans | $137.40 | ↓ -67% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $137.40 | ↓ -67% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $137.40 | ↓ -67% |
| Highmark_Medicare | All_Plans | $138.77 | ↓ -67% |
| Aetna_Medicare | All_Plans | $141.52 | ↓ -66% |
| Aetna_Advantra_Medicare | All_Plans | $141.52 | ↓ -66% |
| United_Medicare | ISNP_DSNP_Plans | $144.27 | ↓ -66% |
| Devoted_Medicare | All_Plans | $144.27 | ↓ -66% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $144.89 | ↓ -66% |
| Amerihealth_Medicare | All_Plans | $144.96 | ↓ -66% |
| Geisinger_Gold_Medicare | All_Plans | $171.75 | ↓ -59% |
| Highmark | Higmark_Healthy_Kids | $210.22 | ↓ -50% |
| UPMC | UPMC_For_Kids | $316.20 | ↓ -25% |
| Aetna | All_Plans | $354.14 | ↓ -16% |
| Cigna | All_Plans | $386.24 | ↓ -8% |
| Geisinger | All_Plans | $389.98 | ↓ -8% |
| Cigna | PPO_Plan | $405.53 | ↓ -4% |
| Highmark | Shared_Cost_Blue_PPO | $463.48 | ↑ +10% |
| Highmark | My_Direct_Blue | $463.48 | ↑ +10% |
| Aetna_Better_Health_Kids | All_Plans | $467.16 | ↑ +11% |
| WellSpan_Capital_Blue_Cross | All_Plans | $474.30 | ↑ +13% |
| First_Health_Network | All_Plans | $500.65 | ↑ +19% |
| United_Healthcare | All_Plans | $502.76 | ↑ +19% |
| Highmark | Blue_Cross_High_Performance_Network | $527.34 | ↑ +25% |
| Highmark | Choice_Blue_PPO | $527.34 | ↑ +25% |
| Highmark | Performance_Blue | $527.34 | ↑ +25% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $230.40 | $20.00 – $307.20 |
| UPMC Bedford | Everett | $121.20 | $36.08 – $181.80 |
| UPMC Cole | Coudersport | $183.00 | $36.75 – $128.00 |
| UPMC Community Osteopathic | Harrisburg | $240.60 | $20.60 – $288.22 |
| UPMC East | Monroeville | $186.60 | $36.08 – $248.80 |
| UPMC Hamot | Erie | $156.60 | $38.50 – $151.40 |
| UPMC Northwest | Seneca | $186.60 | $38.50 – $92.67 |
| UPMC Hanover | Hanover | $61.80 | $44.45 – $88.44 |