Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$817.20
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.
$1,362.00
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.
$38.87 with Highmark BCBS of PA vs $9,539.00 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 BCBS of PA | Medicare | $38.87 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $47.05 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $48.16 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $50.02 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $50.46 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $53.97 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $100.30 | ↓ -88% |
| Prime Net | Managed Medicare | $224.73 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $272.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $272.40 | ↓ -67% |
| Aetna | Medicare | $295.23 | ↓ -64% |
| Geisinger | Medicare | $297.21 | ↓ -64% |
| Cigna | Medicare | $297.21 | ↓ -64% |
| United Healthcare | Medicare | $302.87 | ↓ -63% |
| Keystone Autism Services | ACAP | $452.90 | ↓ -45% |
| Prime Net | ACO/Legacy Commercial | $558.42 | ↓ -32% |
| Aetna | ACO | $562.51 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $649.67 | ↓ -21% |
| Aetna | Commercial | $653.76 | ↓ -20% |
| Geisinger | Commercial | $891.84 | ↑ +9% |
| Highmark BCBS of PA | Medicaid | $937.61 | ↑ +15% |
| Wellspan Population Health | Commercial | $953.40 | ↑ +17% |
| UPMC Health Plan | Commercial | $953.40 | ↑ +17% |
| Highmark BCBS of PA | Commercial | $997.56 | ↑ +22% |
| Prime Net | FH-Medical Rental | $1,014.69 | ↑ +24% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,157.70 | ↑ +42% |
| UPMC Health Plan | CHIP | $1,299.48 | ↑ +59% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +60% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +60% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +60% |
| Cigna | Commercial | $9,539.00 | ↑ +1067% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Arthrocentesis aspir+/injection small jt/bursa with Ultrasound 20604 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $817.20 | $47.05 – $1,157.70 |
| UPMC Community Osteopathic | Harrisburg | $817.20 | $50.02 – $1,299.48 |
| UPMC Hanover | Hanover | $817.20 | $47.05 – $1,016.56 |
| UPMC Lititz | Lititz | $817.20 | $47.05 – $1,016.56 |
| UPMC Magee | Pittsburgh | $199.80 | $40.76 – $303.94 |
| UPMC McKeesport | Mckeesport | $231.00 | $40.76 – $309.57 |
| UPMC Mercy | Pittsburgh | $214.80 | $40.76 – $309.57 |
| UPMC Muncy | Muncy | $922.20 | $40.76 – $993.28 |