healthcosts.net
Proctosigmoidoscopy dx 45300 at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$3,156.60
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.
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What you pay up front if you don't use insurance.
$5,261.00
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.
$26.81 with UPMC Health Plan vs $4,208.80 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 | $26.81 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $26.81 | ↓ -99% |
| UPMC Health Plan | CHIP | $26.81 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $27.48 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $34.24 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $41.53 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $128.48 | ↓ -96% |
| Three Rivers Provider Network | All | $137.45 | ↓ -96% |
| Multiplan | Worker's Compensation | $141.93 | ↓ -96% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $877.73 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $886.59 | ↓ -72% |
| AmeriHealth Caritas | Medicare | $895.29 | ↓ -72% |
| Aetna | Medicare | $895.29 | ↓ -72% |
| United Healthcare | Medicare | $930.05 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↓ -70% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↓ -70% |
| United Healthcare Community Plan for Families | PA Medicaid | $993.28 | ↓ -69% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,093.35 | ↓ -34% |
| Aetna | PEBTF Custom Network | $2,133.34 | ↓ -32% |
| UPMC Health Plan | Commercial | $2,293.80 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $2,465.30 | ↓ -22% |
| Aetna | Commercial | $2,509.50 | ↓ -20% |
| Coventry/First Health | Commercial | $2,635.76 | ↓ -17% |
| Wirerope Works | Commercial | $2,925.12 | ↓ -7% |
| Aetna | First Health | $3,472.26 | ↑ +10% |
| Geisinger | Commercial | $3,524.87 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $3,540.65 | ↑ +12% |
| United Healthcare | Commercial | $3,598.52 | ↑ +14% |
| Cigna | Commercial | $3,603.78 | ↑ +14% |
| Multiplan | Auto | $4,103.58 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $4,103.58 | ↑ +30% |
| America's Choice | PPO | $4,208.80 | ↑ +33% |
| InterGroup | PPO | $4,208.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Proctosigmoidoscopy dx 45300 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,189.80 | $26.81 – $1,685.55 |
| UPMC Presbyterian | Pittsburgh | $1,857.60 | $26.81 – $2,631.60 |
| UPMC Somerset | Somerset | $1,420.20 | $26.81 – $1,775.25 |
| UPMC St. Margaret | Pittsburgh | $1,663.20 | $26.81 – $2,356.20 |
| UPMC Wellsboro | Wellsboro | $3,816.80 | $26.10 – $993.28 |