Bronchoscopy/lung bx each 31628 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$4,452.00
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.
$7,420.00
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.
$223.27 with Highmark Wholecare (prev Gateway) vs $12,459.53 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 | $223.27 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $228.54 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $237.33 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $239.44 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $256.07 | ↓ -94% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $806.22 | ↓ -82% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,004.77 | ↓ -77% |
| Prime Net | Managed Medicare | $1,224.30 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $1,484.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,484.00 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,299.30 | ↓ -48% |
| Prime Net | ACO/Legacy Commercial | $3,042.20 | ↓ -32% |
| Aetna | ACO | $3,064.46 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $3,539.34 | ↓ -21% |
| Aetna | Commercial | $3,561.60 | ↓ -20% |
| Aetna | Medicare | $3,687.44 | ↓ -17% |
| Cigna | Medicare | $3,712.19 | ↓ -17% |
| Geisinger | Medicare | $3,712.19 | ↓ -17% |
| United Healthcare | Medicare | $3,782.90 | ↓ -15% |
| Capital Blue Cross | Commercial | $4,172.70 | ↓ -6% |
| Capital Blue Cross | CHIP | $4,172.70 | ↓ -6% |
| Keystone Health Plan | Commercial | $4,172.70 | ↓ -6% |
| Geisinger | Commercial | $4,858.62 | ↑ +9% |
| Cigna | Commercial | $5,035.00 | ↑ +13% |
| Wellspan Population Health | Commercial | $5,194.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $5,194.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $5,527.90 | ↑ +24% |
| Keystone Autism Services | ACAP | $5,656.67 | ↑ +27% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,307.00 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $11,710.73 | ↑ +163% |
| Highmark BCBS of PA | Commercial | $12,459.53 | ↑ +180% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Bronchoscopy/lung bx each 31628 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,372.20 | $175.80 – $1,829.60 |
| UPMC Bedford | Everett | $4,327.80 | $184.59 – $6,491.70 |
| UPMC Community Osteopathic | Harrisburg | $4,452.00 | $237.33 – $6,307.00 |
| UPMC Hamot | Erie | $4,871.40 | $193.38 – $5,112.40 |
| UPMC Hanover | Hanover | $4,452.00 | $223.27 – $5,635.42 |
| UPMC Jameson | New Castle | $3,435.00 | $193.38 – $4,745.33 |
| UPMC Magee | Pittsburgh | $5,634.60 | $193.38 – $3,796.26 |
| UPMC Mercy | Pittsburgh | $1,829.40 | $193.38 – $3,866.57 |