Acetazolamide 500 mg solution for injection at WellSpan Surgery & Rehabilitation Hospital

55 Monument Road, York PA 17403, PA · Wellspan · · NPI 1760787576

Source: hospital's published price file ↗ · Published Jan 1, 2026 · Ingested Sep 17, 2026

$280.60

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$350.75

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$17.88 with UPMC_Medicaid vs $322.69 with WellSpan_Capital_Blue_Cross — 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 →

Payer
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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
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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_Medicaid All_Plans $17.88 ↓ -94%
Amerihealth_Caritas_Medicaid All_Plans $19.84 ↓ -93%
Health_Partners_Medicaid All_Other_Plans $19.84 ↓ -93%
Geisinger_Medicaid All_Plans $19.84 ↓ -93%
Aetna_Better_Health_Kids All_Plans $21.03 ↓ -93%
United_Healthcare All_Plans $55.14 ↓ -80%
Aetna All_Plans $60.32 ↓ -79%
First_Health_Network All_Plans $60.32 ↓ -79%
Cigna All_Plans $66.71 ↓ -76%
Blue_Cross Capital_Cares_4_kids $75.52 ↓ -73%
Blue_Cross All_Other_Plans $107.88 ↓ -62%
Blue_Cross Capital_Blue_Performance_PPO $107.88 ↓ -62%
UPMC All_Plans $125.09 ↓ -55%
UPMC UPMC_For_Kids $125.09 ↓ -55%
Geisinger All_Plans $125.96 ↓ -55%
Johns_Hopkins_HealthCare_Plan All_Other_Plans $127.78 ↓ -54%
PHC All_Plans $130.47 ↓ -54%
WellSpan_Capital_Blue_Cross All_Plans $322.69 ↑ +15%

Visitor-reported prices

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Acetazolamide 500 mg solution for injection at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Altoona Altoona $100.80 $12.53 – $100.80
UPMC Bedford Everett $128.80 $12.53 – $144.90
UPMC Carlisle Carlisle $25.80 $4.25 – $39.65
UPMC Cole Coudersport $45.60 $19.84 – $60.80
UPMC Community Osteopathic Harrisburg $25.80 $6.20 – $84.25
UPMC East Monroeville $301.60 $12.53 – $301.60
UPMC Hamot Erie $222.40 $12.53 – $76.56
UPMC Northwest Seneca $195.20 $12.53 – $131.32

All Pennsylvania hospitals for this procedure →