healthcosts.net
Surgical pathology level 4 gross & microscopic examination at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$250.20
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.
$417.00
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.
$11.52 with United Healthcare Community Plan for Families vs $333.60 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 | $11.52 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $37.40 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $37.40 | ↓ -85% |
| UPMC Health Plan | CHIP | $37.40 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $38.34 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $47.77 | ↓ -81% |
| Geisinger | CHIP | $50.94 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $51.44 | ↓ -79% |
| UPMC Health Plan | Managed Medicare | $51.96 | ↓ -79% |
| AmeriHealth Caritas | Medicare | $52.47 | ↓ -79% |
| Aetna | Medicare | $52.47 | ↓ -79% |
| United Healthcare | Medicare | $54.51 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $55.01 | ↓ -78% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $55.02 | ↓ -78% |
| PA Health & Wellness | PA Medicaid HMO | $57.94 | ↓ -77% |
| Coventry/First Health | Commercial | $157.63 | ↓ -37% |
| Highmark BCBS of PA | Managed Care - Social Mission | $165.92 | ↓ -34% |
| UPMC Work Partners | Workers Comp | $168.74 | ↓ -33% |
| Aetna | PEBTF Custom Network | $169.09 | ↓ -32% |
| Three Rivers Provider Network | All | $180.51 | ↓ -28% |
| UPMC Health Plan | Commercial | $181.81 | ↓ -27% |
| Multiplan | Worker's Compensation | $186.40 | ↓ -25% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $195.41 | ↓ -22% |
| Aetna | Commercial | $198.91 | ↓ -20% |
| Cigna | Commercial | $214.34 | ↓ -14% |
| United Healthcare | Commercial | $231.44 | ↓ -7% |
| Wirerope Works | Commercial | $231.85 | ↓ -7% |
| Aetna | First Health | $275.22 | ↑ +10% |
| Geisinger | Commercial | $279.39 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $280.64 | ↑ +12% |
| Multiplan | Auto | $325.26 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $325.26 | ↑ +30% |
| America's Choice | PPO | $333.60 | ↑ +33% |
| InterGroup | PPO | $333.60 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 4 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $415.80 | $27.62 – $623.70 |
| UPMC Muncy | Muncy | $250.20 | $11.52 – $333.60 |
| UPMC Northwest | Seneca | $169.20 | $27.80 – $239.70 |
| UPMC Passavant-McCandless | Pittsburgh | $345.00 | $27.79 – $460.70 |
| UPMC Presbyterian | Pittsburgh | $826.20 | $10.80 – $1,170.45 |
| UPMC Somerset | Somerset | $116.40 | $10.35 – $156.82 |
| UPMC St. Margaret | Pittsburgh | $757.20 | $27.86 – $1,072.70 |
| UPMC Wellsboro | Wellsboro | $302.40 | $11.52 – $340.20 |