Athrectomy fem/pop/unilateral 37225 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$17,281.80
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.
$28,803.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $60,682.14 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -94% |
| Prime Net | Managed Medicare | $4,752.49 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $5,760.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $5,760.60 | ↓ -67% |
| Keystone Health Plan | Commercial | $9,437.40 | ↓ -45% |
| Cigna | Commercial | $9,539.00 | ↓ -45% |
| Prime Net | ACO/Legacy Commercial | $11,809.23 | ↓ -32% |
| Aetna | ACO | $11,895.64 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $13,739.03 | ↓ -21% |
| Aetna | Commercial | $13,825.44 | ↓ -20% |
| Highmark BCBS of PA | Medicare | $15,657.27 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $15,841.65 | ↓ -8% |
| UPMC Work Partners | Workers Comp | $16,503.84 | ↓ -5% |
| Aetna | Medicare | $17,959.10 | ↑ +4% |
| Geisinger | Medicare | $18,079.63 | ↑ +5% |
| Cigna | Medicare | $18,079.63 | ↑ +5% |
| United Healthcare | Medicare | $18,424.01 | ↑ +7% |
| Geisinger | Commercial | $18,860.20 | ↑ +9% |
| Wellspan Population Health | Commercial | $20,162.10 | ↑ +17% |
| UPMC Health Plan | Commercial | $20,162.10 | ↑ +17% |
| UPMC Health Plan | CHIP | $20,455.34 | ↑ +18% |
| Prime Net | FH-Medical Rental | $21,458.24 | ↑ +24% |
| Capital Blue Cross | CHIP | $22,309.35 | ↑ +29% |
| Capital Blue Cross | Commercial | $22,309.35 | ↑ +29% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $24,482.55 | ↑ +42% |
| Keystone Autism Services | ACAP | $27,549.92 | ↑ +59% |
| Highmark BCBS of PA | Medicaid | $57,035.22 | ↑ +230% |
| Highmark BCBS of PA | Commercial | $60,682.14 | ↑ +251% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Athrectomy fem/pop/unilateral 37225 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $41,811.00 | $15,770.34 – $55,748.00 |
| UPMC Carlisle | Carlisle | $17,281.80 | $1,016.56 – $27,484.42 |
| UPMC Community Osteopathic | Harrisburg | $17,281.80 | $1,016.56 – $24,482.55 |
| UPMC East | Monroeville | $80,427.00 | $11,685.48 – $107,236.00 |
| UPMC Hamot | Erie | $40,523.40 | $571.49 – $21,338.79 |
| UPMC Northwest | Seneca | $120,934.20 | $14,741.00 – $18,489.15 |
| UPMC Hanover | Hanover | $17,281.80 | $1,016.56 – $27,446.48 |
| UPMC Jameson | New Castle | $16,973.40 | $892.40 – $23,111.43 |