healthcosts.net
Biopsy muscle percutaneous needle at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$1,119.00
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.
$1,865.00
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.
$62.03 with UPMC Health Plan vs $1,668.28 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $62.03 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $62.03 | ↓ -94% |
| UPMC Health Plan | CHIP | $62.03 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $63.58 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $79.23 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $96.10 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $316.98 | ↓ -72% |
| Three Rivers Provider Network | All | $339.09 | ↓ -70% |
| Multiplan | Worker's Compensation | $350.15 | ↓ -69% |
| Highmark BCBS of PA | Managed Care - Social Mission | $742.08 | ↓ -34% |
| Aetna | PEBTF Custom Network | $756.26 | ↓ -32% |
| UPMC Health Plan | Commercial | $813.14 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $873.94 | ↓ -22% |
| Aetna | Commercial | $889.61 | ↓ -20% |
| Coventry/First Health | Commercial | $934.37 | ↓ -16% |
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -11% |
| Wirerope Works | Commercial | $1,036.94 | ↓ -7% |
| Aetna | First Health | $1,230.90 | ↑ +10% |
| Geisinger | Commercial | $1,249.55 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $1,255.14 | ↑ +12% |
| United Healthcare | Commercial | $1,275.66 | ↑ +14% |
| Cigna | Commercial | $1,277.53 | ↑ +14% |
| Multiplan | Auto | $1,454.70 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,454.70 | ↑ +30% |
| America's Choice | PPO | $1,492.00 | ↑ +33% |
| InterGroup | PPO | $1,492.00 | ↑ +33% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,559.84 | ↑ +39% |
| UPMC Health Plan | Managed Medicare | $1,575.59 | ↑ +41% |
| AmeriHealth Caritas | Medicare | $1,591.04 | ↑ +42% |
| Aetna | Medicare | $1,591.04 | ↑ +42% |
| United Healthcare | Medicare | $1,652.83 | ↑ +48% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.12 | ↑ +49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | ↑ +49% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy muscle percutaneous needle at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,757.60 | $62.03 – $3,906.60 |
| UPMC Mercy | Pittsburgh | $1,629.60 | $62.03 – $2,444.40 |
| UPMC Muncy | Muncy | $1,119.00 | $62.03 – $1,492.00 |
| UPMC Northwest | Seneca | $1,891.20 | $62.03 – $2,679.20 |
| UPMC Presbyterian | Pittsburgh | $3,123.60 | $62.03 – $4,425.10 |
| UPMC Somerset | Somerset | $2,461.20 | $62.03 – $3,076.50 |
| UPMC St. Margaret | Pittsburgh | $1,717.20 | $62.03 – $2,432.70 |
| UPMC Wellsboro | Wellsboro | $1,352.80 | $30.96 – $993.28 |