Established Patient Office Visit (level 4) at WellSpan Surgery & Rehabilitation Hospital
55 Monument Road, York PA 17403, PA · Wellspan · · NPI 1760787576
$168.00
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.
?
What you pay up front if you don't use insurance.
$210.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$50.00 with Health_Partners_Medicaid vs $199.50 with Johns_Hopkins_HealthCare_Plan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Health_Partners_Medicaid | All_Other_Plans | $50.00 | ↓ -70% |
| Geisinger_Medicaid | All_Plans | $50.00 | ↓ -70% |
| UPMC_Medicaid | All_Plans | $50.00 | ↓ -70% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $50.00 | ↓ -70% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $50.00 | ↓ -70% |
| Amerihealth_Caritas_Medicaid | All_Plans | $77.28 | ↓ -54% |
| Blue_Cross | Capital_Blue_Performance_PPO | $121.57 | ↓ -28% |
| Blue_Cross | Capital_Cares_4_kids | $124.05 | ↓ -26% |
| United_Medicaid | Community_Plan_For_Kids | $124.76 | ↓ -26% |
| Aetna_Better_Health_Kids | All_Plans | $136.00 | ↓ -19% |
| Aetna | All_Plans | $175.14 | ↑ +4% |
| First_Health_Network | All_Plans | $175.14 | ↑ +4% |
| Cigna | All_Plans | $188.24 | ↑ +12% |
| Blue_Cross | All_Other_Plans | $188.24 | ↑ +12% |
| United_Healthcare | All_Plans | $190.68 | ↑ +14% |
| WellSpan_Capital_Blue_Cross | All_Plans | $193.20 | ↑ +15% |
| UPMC | UPMC_For_Kids | $195.30 | ↑ +16% |
| UPMC | All_Plans | $195.30 | ↑ +16% |
| Geisinger | All_Plans | $196.67 | ↑ +17% |
| PHC | All_Plans | $199.50 | ↑ +19% |
| Johns_Hopkins_HealthCare_Plan | All_Other_Plans | $199.50 | ↑ +19% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $274.20 | $20.00 – $365.60 |
| UPMC Bedford | Everett | $142.20 | $36.08 – $213.30 |
| UPMC Cole | Coudersport | $273.00 | $51.57 – $190.40 |
| UPMC Community Osteopathic | Harrisburg | $271.80 | $31.00 – $337.75 |
| UPMC East | Monroeville | $216.00 | $36.08 – $288.00 |
| UPMC Hamot | Erie | $178.20 | $59.86 – $247.66 |
| UPMC Northwest | Seneca | $201.60 | $59.86 – $122.03 |
| UPMC Hanover | Hanover | $93.00 | $69.11 – $127.70 |