healthcosts.net
Athrectomy fem/pop/unilateral 37225 at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$11,535.60
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.
$19,226.00
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.
$993.28 with United Healthcare Community Plan for Families vs $18,489.15 with PA Health & Wellness — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -91% |
| Highmark BCBS of PA | Managed Care - Social Mission | $7,650.03 | ↓ -34% |
| Aetna | PEBTF Custom Network | $7,796.14 | ↓ -32% |
| UPMC Health Plan | Commercial | $8,382.54 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $9,009.30 | ↓ -22% |
| Aetna | Commercial | $9,170.80 | ↓ -21% |
| Coventry/First Health | Commercial | $9,632.23 | ↓ -16% |
| PA Health & Wellness | PA Medicaid HMO | $10,574.30 | ↓ -8% |
| Wirerope Works | Commercial | $10,689.66 | ↓ -7% |
| Aetna | First Health | $12,689.16 | ↑ +10% |
| Geisinger | Commercial | $12,881.42 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $12,939.10 | ↑ +12% |
| United Healthcare | Commercial | $13,150.58 | ↑ +14% |
| Cigna | Commercial | $13,169.81 | ↑ +14% |
| Multiplan | Auto | $14,996.28 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $14,996.28 | ↑ +30% |
| America's Choice | PPO | $15,380.80 | ↑ +33% |
| InterGroup | PPO | $15,380.80 | ↑ +33% |
| UPMC Work Partners | Workers Comp | $15,770.34 | ↑ +37% |
| Three Rivers Provider Network | All | $16,870.59 | ↑ +46% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $17,287.35 | ↑ +50% |
| Multiplan | Worker's Compensation | $17,420.72 | ↑ +51% |
| UPMC Health Plan | Managed Medicare | $17,461.97 | ↑ +51% |
| Aetna | Medicare | $17,633.17 | ↑ +53% |
| AmeriHealth Caritas | Medicare | $17,633.17 | ↑ +53% |
| United Healthcare | Medicare | $18,317.95 | ↑ +59% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,487.43 | ↑ +60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,489.15 | ↑ +60% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Athrectomy fem/pop/unilateral 37225 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $34,695.00 | $11,399.11 – $49,151.25 |
| UPMC Mercy | Pittsburgh | $34,849.20 | $571.49 – $52,273.80 |
| UPMC Northwest | Seneca | $120,934.20 | $14,741.00 – $171,323.45 |
| UPMC Presbyterian | Pittsburgh | $35,674.80 | $571.49 – $50,539.30 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC St. Margaret | Pittsburgh | $35,730.60 | $11,817.71 – $50,618.35 |