healthcosts.net
Cystostomy cystotomy w/drainage 51040 at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$6,497.40
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.
$10,829.00
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.
$289.60 with UPMC Health Plan vs $8,663.20 with InterGroup — 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 | $289.60 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $289.60 | ↓ -96% |
| UPMC Health Plan | CHIP | $289.60 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $296.84 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $369.89 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $448.66 | ↓ -93% |
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $1,410.81 | ↓ -78% |
| Three Rivers Provider Network | All | $1,509.24 | ↓ -77% |
| Multiplan | Worker's Compensation | $1,558.46 | ↓ -76% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,972.15 | ↓ -70% |
| UPMC Health Plan | Managed Medicare | $1,992.07 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $2,011.60 | ↓ -69% |
| Aetna | Medicare | $2,011.60 | ↓ -69% |
| United Healthcare | Medicare | $2,089.72 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,109.06 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,109.25 | ↓ -68% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,308.86 | ↓ -34% |
| Aetna | PEBTF Custom Network | $4,391.16 | ↓ -32% |
| UPMC Health Plan | Commercial | $4,721.44 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $5,074.47 | ↓ -22% |
| Aetna | Commercial | $5,165.43 | ↓ -21% |
| Coventry/First Health | Commercial | $5,425.33 | ↓ -16% |
| Wirerope Works | Commercial | $6,020.92 | ↓ -7% |
| Aetna | First Health | $7,147.14 | ↑ +10% |
| Geisinger | Commercial | $7,255.43 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $7,287.92 | ↑ +12% |
| United Healthcare | Commercial | $7,407.04 | ↑ +14% |
| Cigna | Commercial | $7,417.86 | ↑ +14% |
| Multiplan | Auto | $8,446.62 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $8,446.62 | ↑ +30% |
| America's Choice | PPO | $8,663.20 | ↑ +33% |
| InterGroup | PPO | $8,663.20 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Cystostomy cystotomy w/drainage 51040 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $4,228.80 | $289.60 – $6,343.20 |
| UPMC Northwest | Seneca | $6,051.00 | $289.60 – $8,572.25 |
| UPMC Presbyterian | Pittsburgh | $6,178.80 | $289.60 – $8,753.30 |
| UPMC Somerset | Somerset | $3,276.00 | $289.60 – $4,095.00 |
| UPMC St. Margaret | Pittsburgh | $4,977.60 | $289.60 – $7,051.60 |