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Acyclovir 400 mg tablet at UPMC Williamsport

700 High Street, Williamsport, PA · UPMC · · NPI 164974648

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

$13.20

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$22.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$5.94 with Aetna vs $19.80 with Three Rivers Provider Network — 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 →

Payer
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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
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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 $5.94 ↓ -55%
UPMC Work Partners Workers Comp $5.97 ↓ -55%
Multiplan Worker's Compensation $6.59 ↓ -50%
Highmark BCBS of PA Managed Care - Social Mission $8.75 ↓ -34%
Aetna PEBTF Custom Network $8.92 ↓ -32%
UPMC Health Plan Commercial $9.59 ↓ -27%
Highmark BCBS of PA Bluecare HMO/FPLIC PPO/Traditional Products $10.31 ↓ -22%
Aetna Commercial $10.49 ↓ -21%
Coventry/First Health Commercial $11.02 ↓ -17%
PA Health & Wellness PA Medicaid HMO $12.10 ↓ -8%
Wirerope Works Commercial $12.23 ↓ -7%
Aetna First Health $14.52 ↑ +10%
Geisinger Commercial $14.74 ↑ +12%
Coventry/First Health FH-Medical Rental $14.81 ↑ +12%
United Healthcare Commercial $15.05 ↑ +14%
Cigna Commercial $15.07 ↑ +14%
Multiplan Auto $17.16 ↑ +30%
Multiplan PPO (Includes PHCS as a Payer) $17.16 ↑ +30%
America's Choice PPO $17.60 ↑ +33%
InterGroup PPO $17.60 ↑ +33%
United Healthcare Community Plan for Families PA Medicaid $19.20 ↑ +45%
Three Rivers Provider Network All $19.80 ↑ +50%

Visitor-reported prices

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Acyclovir 400 mg tablet at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Mercy Pittsburgh not published $0.15 – $0.54
UPMC Northwest Seneca not published $0.04 – $0.51
UPMC St. Margaret Pittsburgh not published $0.04 – $0.51

All Pennsylvania hospitals for this procedure →