Closed tx septal&nose fx at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$3,971.40
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.
$6,619.00
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.
$54.61 with Highmark Wholecare (prev Gateway) vs $10,959.49 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 | $54.61 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $54.61 | ↓ -99% |
| UPMC Health Plan | Managed Medicaid | $55.90 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $58.57 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $62.63 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $544.59 | ↓ -86% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -74% |
| Prime Net | Managed Medicare | $1,092.13 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $1,323.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,323.80 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,316.33 | ↓ -42% |
| Prime Net | ACO/Legacy Commercial | $2,713.79 | ↓ -32% |
| Aetna | ACO | $2,733.65 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $3,157.26 | ↓ -21% |
| Aetna | Commercial | $3,177.12 | ↓ -20% |
| Aetna | Medicare | $3,243.50 | ↓ -18% |
| Cigna | Medicare | $3,265.27 | ↓ -18% |
| Geisinger | Medicare | $3,265.27 | ↓ -18% |
| United Healthcare | Medicare | $3,327.46 | ↓ -16% |
| Capital Blue Cross | Commercial | $4,172.70 | ↑ +5% |
| Capital Blue Cross | CHIP | $4,172.70 | ↑ +5% |
| Keystone Health Plan | Commercial | $4,172.70 | ↑ +5% |
| Geisinger | Commercial | $4,334.12 | ↑ +9% |
| Wellspan Population Health | Commercial | $4,633.30 | ↑ +17% |
| UPMC Health Plan | Commercial | $4,633.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $4,931.15 | ↑ +24% |
| Keystone Autism Services | ACAP | $4,975.65 | ↑ +25% |
| Cigna | Commercial | $5,162.82 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $5,626.15 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $10,300.84 | ↑ +159% |
| Highmark BCBS of PA | Commercial | $10,959.49 | ↑ +176% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Closed tx septal&nose fx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $3,971.40 | $54.61 – $5,626.15 |
| UPMC Community Osteopathic | Harrisburg | $3,971.40 | $54.61 – $5,626.15 |
| UPMC Hanover | Hanover | $3,971.40 | $54.61 – $4,956.96 |
| UPMC Lititz | Lititz | $3,971.40 | $54.61 – $4,983.74 |
| UPMC Somerset | Somerset | $3,971.40 | $47.30 – $3,091.88 |
| UPMC Mercy | Pittsburgh | not published | $47.30 – $3,401.07 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $8,754.00 – $8,754.00 |