healthcosts.net
Removal of toe lesions at UPMC Wellsboro
32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766
$476.40
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.
$794.00
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.
$39.78 with Aetna vs $1,053.44 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 | $39.78 | ↓ -92% |
| Highmark BCBS of PA | Medicare | $44.20 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $44.20 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $45.08 | ↓ -91% |
| Cigna | Medicare | $46.41 | ↓ -90% |
| United Healthcare | Medicare | $47.29 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $47.74 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $94.90 | ↓ -80% |
| UPMC Health Plan | Commercial | $96.36 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $106.15 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $106.15 | ↓ -78% |
| UPMC Health Plan | CHIP | $106.15 | ↓ -78% |
| UPMC Health Plan | Managed Medicaid | $106.15 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $107.60 | ↓ -77% |
| Highmark BCBS of PA | Commercial | $111.76 | ↓ -77% |
| Wirerope Works | Commercial | $122.88 | ↓ -74% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $145.52 | ↓ -69% |
| Geisinger | Commercial | $148.07 | ↓ -69% |
| Aetna | PEBTF Custom Network | $162.13 | ↓ -66% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $164.46 | ↓ -65% |
| Multiplan | Auto | $172.38 | ↓ -64% |
| Multiplan | PPO (Includes PHCS as a Payer) | $172.38 | ↓ -64% |
| United Healthcare | Commercial | $187.85 | ↓ -61% |
| Aetna | Commercial | $190.72 | ↓ -60% |
| America's Choice | PPO | $198.90 | ↓ -58% |
| InterGroup | PPO | $198.90 | ↓ -58% |
| Multiplan | Worker's Compensation | $209.95 | ↓ -56% |
| UPMC Work Partners | Workers Comp | $521.87 | ↑ +10% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,053.44 | ↑ +121% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |