Observation direct referral from physician office for admission at WellSpan Waynesboro Hospital
501 E. Main St., Waynesboro, PA · Wellspan · · NPI 1821091059
$173.60
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.
$217.00
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.
$130.20 with UPMC vs $2,600.00 with Amerihealth_Caritas_Medicaid — 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 | UPMC_For_Kids | $130.20 | ↓ -25% |
| Aetna | All_Plans | $145.82 | ↓ -16% |
| Geisinger | All_Plans | $160.58 | ↓ -8% |
| Cigna | All_Plans | $171.93 | ↓ -1% |
| Cigna | PPO_Plan | $180.52 | ↑ +4% |
| WellSpan_Capital_Blue_Cross | All_Plans | $195.30 | ↑ +13% |
| First_Health_Network | All_Plans | $206.15 | ↑ +19% |
| United_Healthcare | All_Plans | $207.02 | ↑ +19% |
| PA_Health_&_Wellness_Medicare | All_Plans | $652.46 | ↑ +276% |
| Highmark | All_Other_Plans | $653.67 | ↑ +277% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $653.67 | ↑ +277% |
| United_Medicaid | Community_Plan_For_Kids | $653.67 | ↑ +277% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $653.67 | ↑ +277% |
| Highmark_Medicare | All_Plans | $660.21 | ↑ +280% |
| Aetna_Advantra_Medicare | All_Plans | $673.28 | ↑ +288% |
| Aetna_Medicare | All_Plans | $673.28 | ↑ +288% |
| United_Medicare | ISNP_DSNP_Plans | $686.35 | ↑ +295% |
| Devoted_Medicare | All_Plans | $686.35 | ↑ +295% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $689.30 | ↑ +297% |
| Amerihealth_Medicare | All_Plans | $689.62 | ↑ +297% |
| Geisinger_Gold_Medicare | All_Plans | $817.09 | ↑ +371% |
| Highmark | Higmark_Healthy_Kids | $1,000.12 | ↑ +476% |
| Health_Partners_Medicaid | Kidz_Partners | $1,078.56 | ↑ +521% |
| Geisinger_Medicaid | All_Plans | $1,500.00 | ↑ +764% |
| Health_Partners_Medicaid | All_Other_Plans | $1,500.00 | ↑ +764% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $1,500.00 | ↑ +764% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $1,500.00 | ↑ +764% |
| UPMC_Medicaid | All_Plans | $1,500.00 | ↑ +764% |
| Highmark | Shared_Cost_Blue_PPO | $2,204.96 | ↑ +1170% |
| Highmark | My_Direct_Blue | $2,204.96 | ↑ +1170% |
| Highmark | Choice_Blue_PPO | $2,508.79 | ↑ +1345% |
| Highmark | Performance_Blue | $2,508.79 | ↑ +1345% |
| Highmark | Blue_Cross_High_Performance_Network | $2,508.79 | ↑ +1345% |
| Amerihealth_Caritas_Medicaid | All_Plans | $2,600.00 | ↑ +1398% |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $117.00 | $27.00 – $2,064.00 |
| UPMC Bedford | Everett | $166.20 | $31.88 – $2,207.16 |
| UPMC Carlisle | Carlisle | $420.00 | $95.90 – $2,064.00 |
| UPMC Cole | Coudersport | $84.00 | $38.81 – $112.00 |
| UPMC Community Osteopathic | Harrisburg | $420.00 | $169.40 – $3,000.00 |
| UPMC East | Monroeville | $130.20 | $31.88 – $2,207.16 |
| UPMC Hamot | Erie | $138.60 | $674.61 – $728.58 |
| UPMC Northwest | Seneca | $112.80 | $31.88 – $631.28 |