healthcosts.net
Drain thigh/knee lesion 27301 at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$5,397.60
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.
?
What you pay up front if you don't use insurance.
$8,996.00
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.
$97.35 with UPMC Health Plan vs $7,196.80 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $97.35 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $97.35 | ↓ -98% |
| UPMC Health Plan | CHIP | $97.35 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $99.78 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $124.34 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $150.82 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $737.06 | ↓ -86% |
| Three Rivers Provider Network | All | $788.49 | ↓ -85% |
| Multiplan | Worker's Compensation | $814.20 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -82% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,755.36 | ↓ -49% |
| UPMC Health Plan | Managed Medicare | $2,783.19 | ↓ -48% |
| AmeriHealth Caritas | Medicare | $2,810.48 | ↓ -48% |
| Aetna | Medicare | $2,810.48 | ↓ -48% |
| United Healthcare | Medicare | $2,919.62 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,946.64 | ↓ -45% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,946.91 | ↓ -45% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,579.51 | ↓ -34% |
| Aetna | PEBTF Custom Network | $3,647.88 | ↓ -32% |
| UPMC Health Plan | Commercial | $3,922.26 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $4,215.53 | ↓ -22% |
| Aetna | Commercial | $4,291.09 | ↓ -21% |
| Coventry/First Health | Commercial | $4,507.00 | ↓ -16% |
| Wirerope Works | Commercial | $5,001.78 | ↓ -7% |
| Aetna | First Health | $5,937.36 | ↑ +10% |
| Geisinger | Commercial | $6,027.32 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $6,054.31 | ↑ +12% |
| United Healthcare | Commercial | $6,153.26 | ↑ +14% |
| Cigna | Commercial | $6,162.26 | ↑ +14% |
| Multiplan | Auto | $7,016.88 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $7,016.88 | ↑ +30% |
| America's Choice | PPO | $7,196.80 | ↑ +33% |
| InterGroup | PPO | $7,196.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Drain thigh/knee lesion 27301 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,918.20 | $97.35 – $6,967.45 |
| UPMC Muncy | Muncy | $5,397.60 | $97.35 – $7,196.80 |
| UPMC Northwest | Seneca | $5,469.60 | $97.35 – $7,748.60 |
| UPMC Presbyterian | Pittsburgh | $5,768.40 | $97.35 – $8,171.90 |
| UPMC Somerset | Somerset | $7,173.60 | $97.35 – $8,967.00 |
| UPMC Wellsboro | Wellsboro | $6,528.00 | $97.35 – $7,344.00 |
| UPMC St. Margaret | Pittsburgh | not published | $97.35 – $3,001.48 |