healthcosts.net
Ligation/biopsy of temporal artery 37609 at UPMC Wellsboro
32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766
not published by hospital
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.
?
What you pay up front if you don't use insurance.
not published by hospital
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.
?
The hospital's undiscounted list price — almost no one pays this.
$136.40 with AmeriHealth Caritas vs $541.22 with UPMC Work Partners — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $136.40 | — |
| Geisinger | Medicaid/CHIP | $136.40 | — |
| UPMC Health Plan | CHIP | $136.40 | — |
| UPMC Health Plan | Managed Medicaid | $136.40 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $138.26 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $186.99 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $211.32 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $522.24 | — |
| UPMC Work Partners | Workers Comp | $541.22 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ligation/biopsy of temporal artery 37609 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Somerset | Somerset | $4,489.80 | $136.40 – $5,612.25 |
| UPMC Passavant-McCandless | Pittsburgh | not published | $136.40 – $1,699.17 |
| UPMC Mercy | Pittsburgh | not published | $136.40 – $1,699.17 |
| UPMC Northwest | Seneca | not published | $136.40 – $1,621.93 |
| UPMC Presbyterian | Pittsburgh | not published | $136.40 – $1,699.17 |
| UPMC St. Margaret | Pittsburgh | not published | $136.40 – $1,699.17 |