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Pr e&m preventive medicine initial comprehensive new patient 12-17 years at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$103.20
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.
$172.00
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.
$25.60 with United Healthcare Community Plan for Families vs $154.80 with Three Rivers Provider Network — 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 | $25.60 | ↓ -75% |
| Aetna | Medicare | $46.44 | ↓ -55% |
| Highmark BCBS of PA | Managed Care - Social Mission | $68.44 | ↓ -34% |
| Aetna | PEBTF Custom Network | $69.75 | ↓ -32% |
| UPMC Health Plan | Commercial | $74.99 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $80.60 | ↓ -22% |
| Aetna | Commercial | $82.04 | ↓ -21% |
| Coventry/First Health | Commercial | $86.17 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $94.60 | ↓ -8% |
| Wirerope Works | Commercial | $95.63 | ↓ -7% |
| Aetna | First Health | $113.52 | ↑ +10% |
| Geisinger | Commercial | $115.24 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $115.76 | ↑ +12% |
| United Healthcare | Commercial | $117.65 | ↑ +14% |
| Cigna | Commercial | $117.82 | ↑ +14% |
| Multiplan | Auto | $134.16 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $134.16 | ↑ +30% |
| America's Choice | PPO | $137.60 | ↑ +33% |
| InterGroup | PPO | $137.60 | ↑ +33% |
| Three Rivers Provider Network | All | $154.80 | ↑ +50% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Pr e&m preventive medicine initial comprehensive new patient 12-17 years at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Wellsboro | Wellsboro | $178.80 | $25.60 – $140.40 |