Aqua therapy w/exercise/ea 15 min 97113 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$48.00
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.
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What you pay up front if you don't use insurance.
$80.00
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.
$12.19 with Highmark Wholecare (prev Gateway) vs $387.00 with Cigna — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $12.19 | ↓ -75% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.19 | ↓ -75% |
| UPMC Health Plan | Managed Medicaid | $12.48 | ↓ -74% |
| United Healthcare Community Plan for Families | PA Medicaid | $12.58 | ↓ -74% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $13.08 | ↓ -73% |
| Prime Net | Managed Medicare | $13.20 | ↓ -73% |
| Geisinger | Medicaid/CHIP | $13.98 | ↓ -71% |
| Capital Blue Cross | Medicare Advantage | $16.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $16.00 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $20.77 | ↓ -57% |
| Aetna | Medicare | $25.48 | ↓ -47% |
| Prime Net | ACO/Legacy Commercial | $32.80 | ↓ -32% |
| Aetna | ACO | $33.04 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $38.16 | ↓ -21% |
| Aetna | Commercial | $38.40 | ↓ -20% |
| UPMC Work Partners | Workers Comp | $44.00 | ↓ -8% |
| Geisinger | Commercial | $52.38 | ↑ +9% |
| Wellspan Population Health | Commercial | $56.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $56.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $59.60 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $68.00 | ↑ +42% |
| UPMC Health Plan | CHIP | $86.63 | ↑ +80% |
| United Healthcare | Commercial | $148.00 | ↑ +208% |
| Capital Blue Cross | CHIP | $274.05 | ↑ +471% |
| Keystone Health Plan | Commercial | $274.05 | ↑ +471% |
| Capital Blue Cross | Commercial | $274.05 | ↑ +471% |
| Cigna | Commercial | $387.00 | ↑ +706% |
Visitor-reported prices
Comments
Aqua therapy w/exercise/ea 15 min 97113 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $126.00 | $9.60 – $168.00 |
| UPMC Carlisle | Carlisle | $69.60 | $10.96 – $387.00 |
| UPMC Cole | Coudersport | $98.40 | $10.08 – $131.20 |
| UPMC East | Monroeville | $110.40 | $10.56 – $147.20 |
| UPMC Hanover | Hanover | $69.60 | $12.19 – $148.00 |
| UPMC Kane | Kane | $72.00 | $10.56 – $154.77 |
| UPMC Lititz | Lititz | $48.00 | $12.19 – $148.00 |
| UPMC Mercy | Pittsburgh | $126.60 | $10.56 – $60.66 |