Pt evaluation moderate complexity patient/family at WellSpan Surgery & Rehabilitation Hospital
55 Monument Road, York PA 17403, PA · Wellspan · · NPI 1760787576
$312.80
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.
$391.00
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.
$79.51 with UPMC_Medicaid vs $470.73 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 | $79.51 | ↓ -75% |
| Health_Partners_Medicaid | All_Other_Plans | $79.51 | ↓ -75% |
| Geisinger_Medicaid | All_Plans | $79.51 | ↓ -75% |
| Highmark_Wholecare_Gateway_Medicaid | All_Plans | $79.51 | ↓ -75% |
| PA_Health_&_Wellness_Medicaid | All_Plans | $79.51 | ↓ -75% |
| Amerihealth_Caritas_Medicaid | All_Plans | $90.33 | ↓ -71% |
| Blue_Cross_BlueJourney_Medicare | All_Plans | $94.49 | ↓ -70% |
| Johns_Hopkins_HealthCare_Plan | Johns_Hopkins_US_Family_Health | $94.49 | ↓ -70% |
| Highmark_Medicare | All_Plans | $95.43 | ↓ -69% |
| Aetna_Medicare | All_Plans | $97.32 | ↓ -69% |
| Aetna_Advantra_Medicare | All_Plans | $97.32 | ↓ -69% |
| Geisinger_Gold_Medicare | All_Plans | $99.21 | ↓ -68% |
| United_Medicare | ISNP_DSNP_Plans | $99.21 | ↓ -68% |
| Devoted_Medicare | All_Plans | $99.21 | ↓ -68% |
| Highmark_Wholecare_Gateway_Medicare | All_Plans | $99.64 | ↓ -68% |
| Amerihealth_Medicare | All_Plans | $99.69 | ↓ -68% |
| PA_Health_&_Wellness_Medicare | All_Plans | $102.05 | ↓ -67% |
| Jefferson_Health_Medicare_Advantage | All_Plans | $102.05 | ↓ -67% |
| UPMC_Medicare | UPMC_for_Life_Complete_Care | $113.91 | ↓ -64% |
| UPMC_Medicare | UPMC_for_Life_Community_HealthChoices | $113.91 | ↓ -64% |
| Highmark | Higmark_Healthy_Kids | $144.57 | ↓ -54% |
| Health_Partners_Medicaid | Kidz_Partners | $155.91 | ↓ -50% |
| United_Medicaid | Community_Plan_For_Kids | $165.36 | ↓ -47% |
| Aetna_Better_Health_Kids | All_Plans | $216.27 | ↓ -31% |
| Blue_Cross | Capital_Cares_4_kids | $219.53 | ↓ -30% |
| Blue_Cross | Capital_Blue_Performance_PPO | $226.35 | ↓ -28% |
| Blue_Cross | All_Other_Plans | $313.62 | ↑ +0% |
| Aetna | All_Plans | $326.09 | ↑ +4% |
| First_Health_Network | All_Plans | $326.09 | ↑ +4% |
| Cigna | All_Plans | $350.49 | ↑ +12% |
| United_Healthcare | All_Plans | $355.03 | ↑ +14% |
| WellSpan_Capital_Blue_Cross | All_Plans | $359.72 | ↑ +15% |
| UPMC | All_Plans | $363.63 | ↑ +16% |
| UPMC | UPMC_For_Kids | $363.63 | ↑ +16% |
| Geisinger | All_Plans | $366.17 | ↑ +17% |
| Highmark | Blue_Cross_High_Performance_Network | $369.78 | ↑ +18% |
| Highmark | Choice_Blue_PPO | $369.78 | ↑ +18% |
| Highmark | Performance_Blue | $369.78 | ↑ +18% |
| PHC | All_Plans | $371.45 | ↑ +19% |
| Johns_Hopkins_HealthCare_Plan | All_Other_Plans | $371.45 | ↑ +19% |
| Highmark | All_Other_Plans | $470.73 | ↑ +50% |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $216.00 | $51.56 – $288.00 |
| UPMC Bedford | Everett | $299.40 | $124.75 – $449.10 |
| UPMC Carlisle | Carlisle | $303.60 | $33.18 – $430.10 |
| UPMC Cole | Coudersport | $281.40 | $84.11 – $375.20 |
| UPMC Community Osteopathic | Harrisburg | $303.60 | $33.18 – $430.10 |
| UPMC East | Monroeville | $411.60 | $52.05 – $548.80 |
| UPMC Hamot | Erie | $304.80 | $51.56 – $177.27 |
| UPMC Northwest | Seneca | $320.40 | $127.65 – $255.95 |