Bx vag mucos smpl (sep proc) at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$1,452.00
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.
$2,420.00
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.
$76.19 with Highmark Wholecare (prev Gateway) vs $3,397.00 with Cigna — 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 | $76.19 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $76.19 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $77.99 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $81.71 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $87.38 | ↓ -94% |
| Highmark BCBS of PA | Medicare | $106.05 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $289.12 | ↓ -80% |
| Prime Net | Managed Medicare | $399.30 | ↓ -73% |
| UPMC Health Plan | CHIP | $400.57 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $484.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $484.00 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $795.17 | ↓ -45% |
| Aetna | Medicare | $870.85 | ↓ -40% |
| Geisinger | Medicare | $876.70 | ↓ -40% |
| Cigna | Medicare | $876.70 | ↓ -40% |
| United Healthcare | Medicare | $893.40 | ↓ -38% |
| Prime Net | ACO/Legacy Commercial | $992.20 | ↓ -32% |
| Aetna | ACO | $999.46 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $1,154.34 | ↓ -21% |
| Aetna | Commercial | $1,161.60 | ↓ -20% |
| Keystone Autism Services | ACAP | $1,335.92 | ↓ -8% |
| Geisinger | Commercial | $1,584.62 | ↑ +9% |
| Wellspan Population Health | Commercial | $1,694.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,694.00 | ↑ +17% |
| United Healthcare | Commercial | $1,781.12 | ↑ +23% |
| Prime Net | FH-Medical Rental | $1,802.90 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,057.00 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $2,765.69 | ↑ +90% |
| Highmark BCBS of PA | Commercial | $2,942.53 | ↑ +103% |
| Capital Blue Cross | CHIP | $2,966.25 | ↑ +104% |
| Keystone Health Plan | Commercial | $2,966.25 | ↑ +104% |
| Capital Blue Cross | Commercial | $2,966.25 | ↑ +104% |
| Cigna | Commercial | $3,397.00 | ↑ +134% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Bx vag mucos smpl (sep proc) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $1,452.00 | $76.19 – $2,057.00 |
| UPMC Hanover | Hanover | $1,452.00 | $76.19 – $1,330.91 |
| UPMC Kane | Kane | $787.80 | $65.99 – $435.40 |
| UPMC Magee | Pittsburgh | $777.60 | $65.99 – $896.56 |
| UPMC Mercy | Pittsburgh | $711.00 | $65.99 – $913.16 |
| UPMC Presbyterian | Pittsburgh | $966.60 | $65.99 – $913.16 |
| UPMC Somerset | Somerset | $1,452.00 | $65.99 – $830.15 |
| UPMC Wellsboro | Wellsboro | $849.60 | $65.99 – $776.96 |