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Tx phalangeal shaft fx open prox/middle ea at UPMC Wellsboro
32-36 Central Ave, Wellsboro, PA · UPMC · · NPI 1427501766
$6,348.00
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.
$10,580.00
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.
$246.40 with AmeriHealth Caritas vs $10,051.00 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $246.40 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $246.40 | ↓ -96% |
| UPMC Health Plan | CHIP | $246.40 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $246.40 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $249.76 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $337.79 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $381.74 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $948.68 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,152.00 | ↓ -82% |
| Aetna | Medicare | $1,904.40 | ↓ -70% |
| Highmark BCBS of PA | Medicare | $2,116.00 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,116.00 | ↓ -67% |
| UPMC Health Plan | Managed Medicare | $2,158.32 | ↓ -66% |
| Cigna | Medicare | $2,221.80 | ↓ -65% |
| United Healthcare | Medicare | $2,264.12 | ↓ -64% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,285.28 | ↓ -64% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,543.05 | ↓ -28% |
| UPMC Health Plan | Commercial | $4,612.88 | ↓ -27% |
| Highmark BCBS of PA | Commercial | $5,350.31 | ↓ -16% |
| Wirerope Works | Commercial | $5,882.48 | ↓ -7% |
| Geisinger | Commercial | $7,088.60 | ↑ +12% |
| Aetna | PEBTF Custom Network | $7,761.49 | ↑ +22% |
| Multiplan | Auto | $8,252.40 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $8,252.40 | ↑ +30% |
| United Healthcare | Commercial | $8,993.00 | ↑ +42% |
| Aetna | Commercial | $9,130.54 | ↑ +44% |
| America's Choice | PPO | $9,522.00 | ↑ +50% |
| InterGroup | PPO | $9,522.00 | ↑ +50% |
| Multiplan | Worker's Compensation | $10,051.00 | ↑ +58% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Tx phalangeal shaft fx open prox/middle ea at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,776.80 | $246.40 – $8,183.80 |
| UPMC Mercy | Pittsburgh | $4,706.40 | $246.40 – $7,059.60 |
| UPMC Muncy | Muncy | $6,497.40 | $246.40 – $8,663.20 |
| UPMC Northwest | Seneca | $6,170.40 | $246.40 – $8,741.40 |
| UPMC Presbyterian | Pittsburgh | $5,854.20 | $246.40 – $8,293.45 |
| UPMC Williamsport | Williamsport | $6,348.00 | $246.40 – $8,464.00 |