healthcosts.net
Avul nail plate addl at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$114.00
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.
?
What you pay up front if you don't use insurance.
$190.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$28.32 with Geisinger vs $152.00 with InterGroup — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Geisinger | Medicaid/CHIP | $28.32 | ↓ -75% |
| UPMC Health Plan | CHIP | $28.32 | ↓ -75% |
| UPMC Health Plan | Managed Medicaid | $28.32 | ↓ -75% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $29.03 | ↓ -75% |
| United Healthcare Community Plan for Families | PA Medicaid | $32.96 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicaid | $36.18 | ↓ -68% |
| PA Health & Wellness | PA Medicaid HMO | $43.88 | ↓ -62% |
| Aetna | Medicare | $51.30 | ↓ -55% |
| UPMC Work Partners | Workers Comp | $61.80 | ↓ -46% |
| Three Rivers Provider Network | All | $66.11 | ↓ -42% |
| Multiplan | Worker's Compensation | $68.27 | ↓ -40% |
| Highmark BCBS of PA | Managed Care - Social Mission | $75.60 | ↓ -34% |
| Aetna | PEBTF Custom Network | $77.05 | ↓ -32% |
| UPMC Health Plan | Commercial | $82.84 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $89.03 | ↓ -22% |
| Aetna | Commercial | $90.63 | ↓ -21% |
| Coventry/First Health | Commercial | $95.19 | ↓ -17% |
| Wirerope Works | Commercial | $105.64 | ↓ -7% |
| Aetna | First Health | $125.40 | ↑ +10% |
| Geisinger | Commercial | $127.30 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $127.87 | ↑ +12% |
| United Healthcare | Commercial | $129.96 | ↑ +14% |
| Cigna | Commercial | $130.15 | ↑ +14% |
| Multiplan | Auto | $148.20 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $148.20 | ↑ +30% |
| America's Choice | PPO | $152.00 | ↑ +33% |
| InterGroup | PPO | $152.00 | ↑ +33% |
Visitor-reported prices
Comments
Avul nail plate addl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $357.00 | $28.32 – $505.75 |
| UPMC Mercy | Pittsburgh | $388.20 | $28.32 – $582.30 |
| UPMC Muncy | Muncy | $114.00 | $28.32 – $152.00 |
| UPMC Northwest | Seneca | $571.80 | $28.32 – $810.05 |
| UPMC Presbyterian | Pittsburgh | $456.60 | $28.32 – $646.85 |
| UPMC Somerset | Somerset | $370.80 | $28.32 – $463.50 |
| UPMC Wellsboro | Wellsboro | $31.20 | $5.04 – $58.03 |