healthcosts.net
Biopsy muscle percutaneous needle at UPMC Wellsboro
32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766
$1,352.80
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.
$1,865.00
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.
$30.96 with Aetna vs $993.28 with United Healthcare Community Plan for Families — 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 |
|---|---|---|---|
| Aetna | Medicare | $30.96 | ↓ -98% |
| Highmark BCBS of PA | Medicare | $34.40 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicare | $34.40 | ↓ -97% |
| UPMC Health Plan | Managed Medicare | $35.09 | ↓ -97% |
| Cigna | Medicare | $36.12 | ↓ -97% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $37.15 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $62.03 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $62.03 | ↓ -95% |
| UPMC Health Plan | CHIP | $62.03 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $62.03 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $62.87 | ↓ -95% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $73.86 | ↓ -95% |
| UPMC Health Plan | Commercial | $74.99 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $85.04 | ↓ -94% |
| Highmark BCBS of PA | Commercial | $86.98 | ↓ -94% |
| Wirerope Works | Commercial | $95.63 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $96.10 | ↓ -93% |
| Geisinger | Commercial | $115.24 | ↓ -91% |
| Aetna | PEBTF Custom Network | $126.18 | ↓ -91% |
| Multiplan | Auto | $134.16 | ↓ -90% |
| Multiplan | PPO (Includes PHCS as a Payer) | $134.16 | ↓ -90% |
| United Healthcare | Commercial | $146.20 | ↓ -89% |
| Aetna | Commercial | $148.44 | ↓ -89% |
| America's Choice | PPO | $154.80 | ↓ -89% |
| InterGroup | PPO | $154.80 | ↓ -89% |
| Multiplan | Worker's Compensation | $163.40 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $309.58 | ↓ -77% |
| United Healthcare | Medicare | $361.87 | ↓ -73% |
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -27% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy muscle percutaneous needle at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,757.60 | $62.03 – $3,906.60 |
| UPMC Mercy | Pittsburgh | $1,629.60 | $62.03 – $2,444.40 |
| UPMC Muncy | Muncy | $1,119.00 | $62.03 – $1,492.00 |
| UPMC Northwest | Seneca | $1,891.20 | $62.03 – $2,679.20 |
| UPMC Presbyterian | Pittsburgh | $3,123.60 | $62.03 – $4,425.10 |
| UPMC Somerset | Somerset | $2,461.20 | $62.03 – $3,076.50 |
| UPMC St. Margaret | Pittsburgh | $1,717.20 | $62.03 – $2,432.70 |
| UPMC Williamsport | Williamsport | $1,119.00 | $62.03 – $1,492.00 |