healthcosts.net
Repair/graft of tibia at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$13,881.60
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.
$23,136.00
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.
$1,155.84 with United Healthcare Community Plan for Families vs $18,508.80 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,155.84 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $3,077.12 | ↓ -78% |
| Three Rivers Provider Network | All | $3,291.81 | ↓ -76% |
| Multiplan | Worker's Compensation | $3,399.15 | ↓ -76% |
| Aetna | Medicare | $6,246.72 | ↓ -55% |
| Highmark BCBS of PA | Managed Care - Social Mission | $9,205.81 | ↓ -34% |
| Aetna | PEBTF Custom Network | $9,381.65 | ↓ -32% |
| UPMC Health Plan | Commercial | $10,087.30 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $10,841.53 | ↓ -22% |
| Aetna | Commercial | $11,035.87 | ↓ -21% |
| Coventry/First Health | Commercial | $11,591.14 | ↓ -16% |
| PA Health & Wellness | PA Medicaid HMO | $12,724.80 | ↓ -8% |
| Wirerope Works | Commercial | $12,863.62 | ↓ -7% |
| Aetna | First Health | $15,269.76 | ↑ +10% |
| Geisinger | Commercial | $15,501.12 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $15,570.53 | ↑ +12% |
| United Healthcare | Commercial | $15,825.02 | ↑ +14% |
| Cigna | Commercial | $15,848.16 | ↑ +14% |
| Multiplan | Auto | $18,046.08 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $18,046.08 | ↑ +30% |
| America's Choice | PPO | $18,508.80 | ↑ +33% |
| InterGroup | PPO | $18,508.80 | ↑ +33% |