healthcosts.net
Cover eye w/membrane at UPMC Wellsboro
32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766
$17,461.60
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.
$24,064.00
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.
$993.28 with United Healthcare Community Plan for Families vs $20,735.65 with Multiplan — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $1,838.17 | ↓ -89% |
| Aetna | Medicare | $3,928.86 | ↓ -78% |
| Highmark BCBS of PA | Medicare | $4,365.40 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,365.40 | ↓ -75% |
| UPMC Health Plan | Managed Medicare | $4,452.71 | ↓ -74% |
| Cigna | Medicare | $4,583.67 | ↓ -74% |
| United Healthcare | Medicare | $4,670.98 | ↓ -73% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4,714.63 | ↓ -73% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $9,372.51 | ↓ -46% |
| UPMC Health Plan | Commercial | $9,516.57 | ↓ -46% |
| Highmark BCBS of PA | Commercial | $11,037.91 | ↓ -37% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $12,004.85 | ↓ -31% |
| Wirerope Works | Commercial | $12,135.81 | ↓ -31% |
| Geisinger | Commercial | $14,624.09 | ↓ -16% |
| Aetna | PEBTF Custom Network | $16,012.29 | ↓ -8% |
| Multiplan | Auto | $17,025.06 | ↓ -3% |
| Multiplan | PPO (Includes PHCS as a Payer) | $17,025.06 | ↓ -3% |
| United Healthcare | Commercial | $18,552.95 | ↑ +6% |
| Aetna | Commercial | $18,836.70 | ↑ +8% |
| America's Choice | PPO | $19,644.30 | ↑ +13% |
| InterGroup | PPO | $19,644.30 | ↑ +13% |
| Multiplan | Worker's Compensation | $20,735.65 | ↑ +19% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Cover eye w/membrane at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $11,560.20 | $858.11 – $16,376.95 |
| UPMC Muncy | Muncy | $14,438.40 | $993.28 – $19,251.20 |
| UPMC Presbyterian | Pittsburgh | $17,159.40 | $931.20 – $24,309.15 |