Auditor evoke potent limit at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$595.80
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.
$993.00
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.
$163.84 with Prime Net vs $844.05 with Multiplan — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $163.84 | ↓ -73% |
| Aetna | Medicare | $197.61 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $198.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $198.60 | ↓ -67% |
| Prime Net | ACO/Legacy Commercial | $407.13 | ↓ -32% |
| Aetna | ACO | $410.11 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $473.66 | ↓ -21% |
| Aetna | Commercial | $476.64 | ↓ -20% |
| Highmark BCBS of PA | Medicare | $491.54 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $546.15 | ↓ -8% |
| Capital Blue Cross | Commercial | $601.16 | ↑ +1% |
| Capital Blue Cross | CHIP | $601.16 | ↑ +1% |
| Keystone Health Plan | Commercial | $631.25 | ↑ +6% |
| Geisinger | Commercial | $650.22 | ↑ +9% |
| UPMC Health Plan | CHIP | $695.10 | ↑ +17% |
| Wellspan Population Health | Commercial | $695.10 | ↑ +17% |
| UPMC Health Plan | Commercial | $695.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $739.78 | ↑ +24% |
| United Healthcare | Commercial | $761.00 | ↑ +28% |
| Cigna | Commercial | $774.54 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $844.05 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Auditor evoke potent limit at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $595.80 | $136.04 – $844.05 |
| UPMC Community Osteopathic | Harrisburg | $595.80 | $198.60 – $844.05 |
| UPMC Hanover | Hanover | $595.80 | $761.00 – $761.00 |
| UPMC Lititz | Lititz | $595.80 | $761.00 – $761.00 |