Chemotherapy injection 96542 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$288.00
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.
$480.00
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.
$47.54 with Highmark Wholecare (prev Gateway) vs $1,120.91 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 | $47.54 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $47.54 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $48.66 | ↓ -83% |
| United Healthcare Community Plan for Families | PA Medicaid | $49.03 | ↓ -83% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $50.98 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $54.52 | ↓ -81% |
| Prime Net | Managed Medicare | $79.20 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $96.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $96.00 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $140.26 | ↓ -51% |
| Prime Net | ACO/Legacy Commercial | $196.80 | ↓ -32% |
| Aetna | ACO | $198.24 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $228.96 | ↓ -21% |
| Aetna | Commercial | $230.40 | ↓ -20% |
| UPMC Work Partners | Workers Comp | $236.18 | ↓ -18% |
| UPMC Health Plan | CHIP | $276.19 | ↓ -4% |
| Capital Blue Cross | Commercial | $290.59 | ↑ +1% |
| Capital Blue Cross | CHIP | $290.59 | ↑ +1% |
| Keystone Health Plan | Commercial | $305.14 | ↑ +6% |
| Geisinger | Commercial | $314.30 | ↑ +9% |
| Aetna | Medicare | $331.74 | ↑ +15% |
| Geisinger | Medicare | $333.96 | ↑ +16% |
| Cigna | Medicare | $333.96 | ↑ +16% |
| Wellspan Population Health | Commercial | $336.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $336.00 | ↑ +17% |
| United Healthcare | Medicare | $340.32 | ↑ +18% |
| Prime Net | FH-Medical Rental | $357.60 | ↑ +24% |
| Cigna | Commercial | $374.40 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $408.00 | ↑ +42% |
| Keystone Autism Services | ACAP | $508.90 | ↑ +77% |
| United Healthcare | Commercial | $793.00 | ↑ +175% |
| Highmark BCBS of PA | Medicaid | $1,053.54 | ↑ +266% |
| Highmark BCBS of PA | Commercial | $1,120.91 | ↑ +289% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Chemotherapy injection 96542 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $978.00 | $37.43 – $1,304.00 |
| UPMC Carlisle | Carlisle | $288.00 | $47.54 – $507.68 |
| UPMC Cole | Coudersport | $490.20 | $39.30 – $653.60 |
| UPMC Community Osteopathic | Harrisburg | $288.00 | $47.54 – $408.00 |
| UPMC Hanover | Hanover | $288.00 | $47.54 – $506.98 |
| UPMC Lititz | Lititz | $288.00 | $47.54 – $509.71 |
| UPMC Magee | Pittsburgh | $433.80 | $41.17 – $341.53 |
| UPMC Somerset | Somerset | $288.00 | $41.17 – $316.23 |