Bx breast pq tomo guide at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$7,249.80
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.
$12,083.00
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.
$15.15 with Highmark BCBS of PA 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 BCBS of PA | Medicare | $15.15 | ↓ -100% |
| UPMC Health Plan | CHIP | $47.21 | ↓ -99% |
| Prime Net | Managed Medicare | $1,993.69 | ↓ -73% |
| Aetna | Medicare | $2,404.52 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $2,416.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,416.60 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $2,747.15 | ↓ -62% |
| Geisinger | Medicare | $3,855.49 | ↓ -47% |
| Cigna | Medicare | $3,855.49 | ↓ -47% |
| United Healthcare | Medicare | $3,928.93 | ↓ -46% |
| Prime Net | ACO/Legacy Commercial | $4,954.03 | ↓ -32% |
| Aetna | ACO | $4,990.28 | ↓ -31% |
| Capital Blue Cross | CHIP | $5,588.10 | ↓ -23% |
| Keystone Health Plan | Commercial | $5,588.10 | ↓ -23% |
| Capital Blue Cross | Commercial | $5,588.10 | ↓ -23% |
| Prime Net | GateKeeper/NonGateKeeper | $5,763.59 | ↓ -21% |
| Aetna | Commercial | $5,799.84 | ↓ -20% |
| Keystone Autism Services | ACAP | $5,875.04 | ↓ -19% |
| Geisinger | Medicaid/CHIP | $6,645.65 | ↓ -8% |
| Geisinger | Commercial | $7,911.95 | ↑ +9% |
| Wellspan Population Health | Commercial | $8,458.10 | ↑ +17% |
| UPMC Health Plan | Commercial | $8,458.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $9,001.83 | ↑ +24% |
| Cigna | Commercial | $9,539.00 | ↑ +32% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $10,270.55 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $12,162.80 | ↑ +68% |
| Highmark BCBS of PA | Commercial | $12,940.51 | ↑ +78% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Bx breast pq tomo guide at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $7,249.80 | $47.21 – $10,270.55 |
| UPMC Community Osteopathic | Harrisburg | $7,249.80 | $47.21 – $10,270.55 |
| UPMC Hanover | Hanover | $7,249.80 | $47.21 – $5,852.98 |
| UPMC Lititz | Lititz | $7,249.80 | $47.21 – $5,884.59 |
| UPMC Somerset | Somerset | $7,249.80 | $18.40 – $3,942.46 |
| WellSpan Ephrata Community Hospital | Ephrata | $2,424.80 | $2,871.96 – $2,871.96 |
| WellSpan Evangelical Community Hospital | Lewisburg | $9,758.40 | $86.34 – $86.34 |
| WellSpan Good Samaritan Hospital | Lebanon | $2,471.20 | $157.32 – $6,066.00 |