healthcosts.net
Surgical pathology level 6 gross & microscopic examination at UPMC Williamsport
700 High Street, Williamsport, PA · UPMC · · NPI 164974648
$619.20
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.
$1,032.00
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.
$22.40 with United Healthcare Community Plan for Families vs $841.13 with PA Health & Wellness — 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 | $22.40 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $74.36 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $74.36 | ↓ -88% |
| UPMC Health Plan | CHIP | $74.36 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $76.22 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $94.98 | ↓ -85% |
| PA Health & Wellness | PA Medicaid HMO | $115.20 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $389.27 | ↓ -37% |
| Coventry/First Health | Commercial | $390.10 | ↓ -37% |
| Highmark BCBS of PA | Managed Care - Social Mission | $410.63 | ↓ -34% |
| Three Rivers Provider Network | All | $416.43 | ↓ -33% |
| Aetna | PEBTF Custom Network | $418.48 | ↓ -32% |
| Multiplan | Worker's Compensation | $430.01 | ↓ -31% |
| UPMC Health Plan | Commercial | $449.95 | ↓ -27% |
| Highmark BCBS of PA | Bluecare HMO/FPLIC PPO/Traditional Products | $483.60 | ↓ -22% |
| Aetna | Commercial | $492.26 | ↓ -21% |
| Cigna | Commercial | $530.45 | ↓ -14% |
| United Healthcare | Commercial | $572.76 | ↓ -8% |
| Wirerope Works | Commercial | $573.79 | ↓ -7% |
| Aetna | First Health | $681.12 | ↑ +10% |
| Geisinger | Commercial | $691.44 | ↑ +12% |
| Coventry/First Health | FH-Medical Rental | $694.54 | ↑ +12% |
| Geisinger | CHIP | $778.82 | ↑ +26% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $786.45 | ↑ +27% |
| UPMC Health Plan | Managed Medicare | $794.40 | ↑ +28% |
| AmeriHealth Caritas | Medicare | $802.18 | ↑ +30% |
| Aetna | Medicare | $802.18 | ↑ +30% |
| Multiplan | Auto | $804.96 | ↑ +30% |
| Multiplan | PPO (Includes PHCS as a Payer) | $804.96 | ↑ +30% |
| America's Choice | PPO | $825.60 | ↑ +33% |
| InterGroup | PPO | $825.60 | ↑ +33% |
| United Healthcare | Medicare | $833.34 | ↑ +35% |
| Highmark Wholecare (prev Gateway) | Medicare | $841.05 | ↑ +36% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $841.13 | ↑ +36% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 6 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $669.60 | $54.35 – $1,004.40 |
| UPMC Muncy | Muncy | $619.20 | $22.40 – $825.60 |
| UPMC Northwest | Seneca | $691.20 | $54.70 – $979.20 |
| UPMC Passavant-McCandless | Pittsburgh | $610.80 | $54.67 – $865.30 |
| UPMC Presbyterian | Pittsburgh | $1,452.60 | $21.00 – $2,057.85 |
| UPMC Somerset | Somerset | $1,472.40 | $20.12 – $1,840.50 |
| UPMC St. Margaret | Pittsburgh | $301.20 | $54.81 – $817.76 |
| UPMC Wellsboro | Wellsboro | $748.80 | $22.40 – $842.40 |