X-ray exam of eye sockets at WellSpan Waynesboro Hospital
501 E. Main St., Waynesboro, PA · Wellspan · · NPI 1821091059
$272.00
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.
$340.00
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.
$35.55 with UPMC_Medicare vs $602.31 with United_Healthcare — 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_Complete_Care | $35.55 | ↓ -87% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $35.55 | ↓ -87% |
| UPMC_Medicaid | All_Plans | $35.72 | ↓ -87% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $42.33 | ↓ -84% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $42.33 | ↓ -84% |
| Geisinger_Medicaid | All_Plans | $42.33 | ↓ -84% |
| Amerihealth_Caritas_Medicaid | All_Plans | $48.08 | ↓ -82% |
| WellSpan_Capital_Blue_Cross | All_Plans | $104.00 | ↓ -62% |
| Health_Partners_Medicaid | All_Other_Plans | $105.41 | ↓ -61% |
| PA_Health_&_Wellness_Medicare | All_Plans | $113.17 | ↓ -58% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $113.38 | ↓ -58% |
| Highmark | All_Other_Plans | $113.38 | ↓ -58% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $113.38 | ↓ -58% |
| United_Medicaid | Community_Plan_For_Kids | $113.38 | ↓ -58% |
| Highmark_Medicare | All_Plans | $114.51 | ↓ -58% |
| Aetna_Medicare | All_Plans | $116.78 | ↓ -57% |
| Aetna_Advantra_Medicare | All_Plans | $116.78 | ↓ -57% |
| Devoted_Medicare | All_Plans | $119.05 | ↓ -56% |
| United_Medicare | ISNP_DSNP_Plans | $119.05 | ↓ -56% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $119.56 | ↓ -56% |
| Amerihealth_Medicare | All_Plans | $119.62 | ↓ -56% |
| Geisinger_Gold_Medicare | All_Plans | $141.73 | ↓ -48% |
| Blue_Cross | Capital_Cares_4_kids | $172.30 | ↓ -37% |
| Highmark | Higmark_Healthy_Kids | $173.47 | ↓ -36% |
| Health_Partners_Medicaid | Kidz_Partners | $187.08 | ↓ -31% |
| UPMC | UPMC_For_Kids | $204.00 | ↓ -25% |
| Aetna | All_Plans | $228.48 | ↓ -16% |
| Blue_Cross | All_Other_Plans | $246.14 | ↓ -10% |
| Cigna | All_Plans | $249.19 | ↓ -8% |
| Geisinger | All_Plans | $251.60 | ↓ -8% |
| Cigna | PPO_Plan | $261.63 | ↓ -4% |
| First_Health_Network | All_Plans | $323.00 | ↑ +19% |
| Highmark | Shared_Cost_Blue_PPO | $382.45 | ↑ +41% |
| Highmark | My_Direct_Blue | $382.45 | ↑ +41% |
| Aetna_Better_Health_Kids | All_Plans | $385.49 | ↑ +42% |
| Highmark | Performance_Blue | $435.15 | ↑ +60% |
| Highmark | Choice_Blue_PPO | $435.15 | ↑ +60% |
| Highmark | Blue_Cross_High_Performance_Network | $435.15 | ↑ +60% |
| United_Healthcare | All_Plans | $602.31 | ↑ +121% |
Visitor-reported prices
Comments
X-ray exam of eye sockets at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $111.00 | $21.00 – $148.00 |
| UPMC Bedford | Everett | $141.00 | $35.55 – $211.50 |
| UPMC Carlisle | Carlisle | $262.80 | $27.51 – $372.30 |
| UPMC Cole | Coudersport | $170.40 | $35.55 – $227.20 |
| UPMC Community Osteopathic | Harrisburg | $262.80 | $27.51 – $372.30 |
| UPMC East | Monroeville | $436.20 | $37.25 – $581.60 |
| UPMC Hamot | Erie | $340.20 | $32.52 – $166.40 |
| UPMC Northwest | Seneca | $194.40 | $37.25 – $106.45 |