healthcosts.net
Repair deformity of toe at UPMC Wellsboro
32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766
$624.60
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.
$1,041.00
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.
$52.92 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 | $52.92 | ↓ -92% |
| Highmark BCBS of PA | Medicare | $58.80 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $58.80 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $59.98 | ↓ -90% |
| Cigna | Medicare | $61.74 | ↓ -90% |
| United Healthcare | Medicare | $62.92 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $63.50 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $126.24 | ↓ -80% |
| UPMC Health Plan | Commercial | $128.18 | ↓ -79% |
| Highmark BCBS of PA | Commercial | $148.68 | ↓ -76% |
| Wirerope Works | Commercial | $163.46 | ↓ -74% |
| Geisinger | Commercial | $196.98 | ↓ -68% |
| Aetna | PEBTF Custom Network | $215.68 | ↓ -65% |
| Multiplan | Auto | $229.32 | ↓ -63% |
| Multiplan | PPO (Includes PHCS as a Payer) | $229.32 | ↓ -63% |
| United Healthcare | Commercial | $249.90 | ↓ -60% |
| Aetna | Commercial | $253.72 | ↓ -59% |
| America's Choice | PPO | $264.60 | ↓ -58% |
| InterGroup | PPO | $264.60 | ↓ -58% |
| Multiplan | Worker's Compensation | $279.30 | ↓ -55% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $343.20 | ↓ -45% |
| Geisinger | Medicaid/CHIP | $343.20 | ↓ -45% |
| UPMC Health Plan | CHIP | $343.20 | ↓ -45% |
| UPMC Health Plan | Managed Medicaid | $343.20 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicaid | $347.88 | ↓ -44% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $470.50 | ↓ -25% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $531.71 | ↓ -15% |
| UPMC Work Partners | Workers Comp | $712.49 | ↑ +14% |
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↑ +59% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |