Canthotomy 67715 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$3,228.00
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.
$5,380.00
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.
$353.72 with UPMC Work Partners vs $7,883.92 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $353.72 | ↓ -89% |
| Highmark BCBS of PA | Medicare | $444.23 | ↓ -86% |
| Prime Net | Managed Medicare | $887.70 | ↓ -73% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -69% |
| Keystone Health Plan | Medicare Advantage | $1,076.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,076.00 | ↓ -67% |
| UPMC Health Plan | CHIP | $1,731.80 | ↓ -46% |
| Prime Net | ACO/Legacy Commercial | $2,205.80 | ↓ -32% |
| Aetna | ACO | $2,221.94 | ↓ -31% |
| Aetna | Medicare | $2,333.27 | ↓ -28% |
| Geisinger | Medicare | $2,348.93 | ↓ -27% |
| Cigna | Medicare | $2,348.93 | ↓ -27% |
| United Healthcare | Medicare | $2,393.68 | ↓ -26% |
| Prime Net | GateKeeper/NonGateKeeper | $2,566.26 | ↓ -21% |
| Aetna | Commercial | $2,582.40 | ↓ -20% |
| Geisinger | Medicaid/CHIP | $2,959.00 | ↓ -8% |
| Geisinger | Commercial | $3,522.82 | ↑ +9% |
| Keystone Autism Services | ACAP | $3,579.33 | ↑ +11% |
| Wellspan Population Health | Commercial | $3,766.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $3,766.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $4,008.10 | ↑ +24% |
| Cigna | Commercial | $4,196.40 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,573.00 | ↑ +42% |
| Capital Blue Cross | CHIP | $5,588.10 | ↑ +73% |
| Keystone Health Plan | Commercial | $5,588.10 | ↑ +73% |
| Capital Blue Cross | Commercial | $5,588.10 | ↑ +73% |
| Highmark BCBS of PA | Medicaid | $7,410.10 | ↑ +130% |
| Highmark BCBS of PA | Commercial | $7,883.92 | ↑ +144% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Canthotomy 67715 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $3,228.00 | $257.98 – $4,573.00 |
| UPMC Community Osteopathic | Harrisburg | $3,228.00 | $353.72 – $4,573.00 |
| UPMC Hamot | Erie | $3,141.60 | $322.00 – $3,234.93 |
| UPMC Northwest | Seneca | $3,352.80 | $338.00 – $2,402.14 |
| UPMC Hanover | Hanover | $3,228.00 | $353.72 – $3,565.89 |
| UPMC Lititz | Lititz | $3,228.00 | $257.98 – $3,585.14 |
| UPMC Mercy | Pittsburgh | $2,630.40 | $330.44 – $2,446.62 |
| UPMC Presbyterian | Pittsburgh | $3,948.00 | $330.44 – $2,446.62 |