Biopsy/excision of lymph node(s); open deep 38530 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$4,592.40
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.
$7,654.00
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.
$280.67 with Highmark Wholecare (prev Gateway) vs $12,940.51 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $280.67 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $287.30 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $298.35 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $301.00 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $321.91 | ↓ -93% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $924.65 | ↓ -80% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,172.45 | ↓ -74% |
| Prime Net | Managed Medicare | $1,262.91 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $1,530.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,530.80 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,297.62 | ↓ -50% |
| Prime Net | ACO/Legacy Commercial | $3,138.14 | ↓ -32% |
| Aetna | ACO | $3,161.10 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $3,650.96 | ↓ -20% |
| Aetna | Commercial | $3,673.92 | ↓ -20% |
| Aetna | Medicare | $3,829.79 | ↓ -17% |
| Cigna | Medicare | $3,855.49 | ↓ -16% |
| Geisinger | Medicare | $3,855.49 | ↓ -16% |
| United Healthcare | Medicare | $3,928.93 | ↓ -14% |
| Geisinger | Commercial | $5,011.84 | ↑ +9% |
| Cigna | Commercial | $5,035.00 | ↑ +10% |
| Wellspan Population Health | Commercial | $5,357.80 | ↑ +17% |
| UPMC Health Plan | Commercial | $5,357.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $5,702.23 | ↑ +24% |
| Keystone Autism Services | ACAP | $5,875.04 | ↑ +28% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,505.90 | ↑ +42% |
| Capital Blue Cross | CHIP | $7,073.85 | ↑ +54% |
| Capital Blue Cross | Commercial | $7,073.85 | ↑ +54% |
| Keystone Health Plan | Commercial | $7,105.35 | ↑ +55% |
| Highmark BCBS of PA | Medicaid | $12,162.80 | ↑ +165% |
| Highmark BCBS of PA | Commercial | $12,940.51 | ↑ +182% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy/excision of lymph node(s); open deep 38530 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,592.40 | $280.67 – $6,505.90 |
| UPMC Community Osteopathic | Harrisburg | $4,592.40 | $298.35 – $6,505.90 |
| UPMC Hanover | Hanover | $4,592.40 | $280.67 – $5,852.98 |
| UPMC Lititz | Lititz | $4,592.40 | $280.67 – $5,884.59 |
| UPMC Somerset | Somerset | $4,592.40 | $243.10 – $3,650.76 |
| UPMC Hamot | Erie | not published | $243.10 – $5,309.76 |
| UPMC Northwest | Seneca | not published | $243.10 – $3,833.30 |