Ot re-evaluation patient/family at WellSpan Surgery & Rehabilitation Hospital
55 Monument Road, York PA 17403, PA · Wellspan · · NPI 1760787576
$206.40
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.
$258.00
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.
$50.86 with UPMC_Medicaid vs $332.44 with Highmark — 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 |
|---|---|---|---|
| UPMC_Medicaid | All_Plans | $50.86 | ↓ -75% |
| Health_Partners_Medicaid | All_Other_Plans | $50.86 | ↓ -75% |
| Geisinger_Medicaid | All_Plans | $50.86 | ↓ -75% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $50.86 | ↓ -75% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $50.86 | ↓ -75% |
| Amerihealth_Caritas_Medicaid | All_Plans | $57.78 | ↓ -72% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $66.73 | ↓ -68% |
| Johns_Hopkins_HealthCare_Plan | Johns_Hopkins_US_Family_Health | $66.73 | ↓ -68% |
| Highmark_Medicare | All_Plans | $67.40 | ↓ -67% |
| Aetna_Medicare | All_Plans | $68.73 | ↓ -67% |
| Aetna_Advantra_Medicare | All_Plans | $68.73 | ↓ -67% |
| Geisinger_Gold_Medicare | All_Plans | $70.07 | ↓ -66% |
| United_Medicare | ISNP_DSNP_Plans | $70.07 | ↓ -66% |
| Devoted_Medicare | All_Plans | $70.07 | ↓ -66% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $70.37 | ↓ -66% |
| Amerihealth_Medicare | All_Plans | $70.40 | ↓ -66% |
| PA_Health_&_Wellness_Medicare | All_Plans | $72.07 | ↓ -65% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $72.07 | ↓ -65% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $80.44 | ↓ -61% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $80.44 | ↓ -61% |
| Highmark | Higmark_Healthy_Kids | $102.10 | ↓ -51% |
| Health_Partners_Medicaid | Kidz_Partners | $110.10 | ↓ -47% |
| United_Medicaid | Community_Plan_For_Kids | $116.78 | ↓ -43% |
| Aetna_Better_Health_Kids | All_Plans | $138.35 | ↓ -33% |
| Blue_Cross | Capital_Cares_4_kids | $144.86 | ↓ -30% |
| Blue_Cross | Capital_Blue_Performance_PPO | $149.36 | ↓ -28% |
| Blue_Cross | All_Other_Plans | $206.94 | ↑ +0% |
| Aetna | All_Plans | $215.17 | ↑ +4% |
| First_Health_Network | All_Plans | $215.17 | ↑ +4% |
| Cigna | All_Plans | $231.27 | ↑ +12% |
| United_Healthcare | All_Plans | $234.26 | ↑ +13% |
| WellSpan_Capital_Blue_Cross | All_Plans | $237.36 | ↑ +15% |
| UPMC | UPMC_For_Kids | $239.94 | ↑ +16% |
| UPMC | All_Plans | $239.94 | ↑ +16% |
| Geisinger | All_Plans | $241.62 | ↑ +17% |
| Johns_Hopkins_HealthCare_Plan | All_Other_Plans | $245.10 | ↑ +19% |
| PHC | All_Plans | $245.10 | ↑ +19% |
| Highmark | Performance_Blue | $261.14 | ↑ +27% |
| Highmark | Choice_Blue_PPO | $261.14 | ↑ +27% |
| Highmark | Blue_Cross_High_Performance_Network | $261.14 | ↑ +27% |
| Highmark | All_Other_Plans | $332.44 | ↑ +61% |
Visitor-reported prices
Comments
Ot re-evaluation patient/family at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $113.40 | $32.98 – $151.20 |
| UPMC Bedford | Everett | $125.40 | $42.72 – $188.10 |
| UPMC Carlisle | Carlisle | $138.60 | $31.65 – $387.00 |
| UPMC Cole | Coudersport | $118.80 | $42.72 – $158.40 |
| UPMC Community Osteopathic | Harrisburg | $138.60 | $46.20 – $204.46 |
| UPMC East | Monroeville | $155.40 | $33.29 – $207.20 |
| UPMC Hamot | Erie | $147.60 | $32.98 – $121.18 |
| UPMC Northwest | Seneca | $105.00 | $44.76 – $85.58 |