Clsd tx/metatarsal fx without manip 28470 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$520.80
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.
$868.00
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.
$106.05 with Highmark BCBS of PA vs $1,310.40 with Capital Blue Cross — 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 | $106.05 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicaid | $107.31 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $107.31 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $109.85 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $115.09 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $123.08 | ↓ -76% |
| Prime Net | Managed Medicare | $143.22 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $173.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $173.60 | ↓ -67% |
| Aetna | Medicare | $239.91 | ↓ -54% |
| Geisinger | Medicare | $241.52 | ↓ -54% |
| Cigna | Medicare | $241.52 | ↓ -54% |
| United Healthcare | Medicare | $246.12 | ↓ -53% |
| Prime Net | ACO/Legacy Commercial | $355.88 | ↓ -32% |
| Aetna | ACO | $358.48 | ↓ -31% |
| Keystone Autism Services | ACAP | $368.03 | ↓ -29% |
| UPMC Work Partners | Workers Comp | $386.84 | ↓ -26% |
| Prime Net | GateKeeper/NonGateKeeper | $414.04 | ↓ -20% |
| Aetna | Commercial | $416.64 | ↓ -20% |
| UPMC Health Plan | CHIP | $419.89 | ↓ -19% |
| Geisinger | Commercial | $568.37 | ↑ +9% |
| Wellspan Population Health | Commercial | $607.60 | ↑ +17% |
| UPMC Health Plan | Commercial | $607.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $646.66 | ↑ +24% |
| Cigna | Commercial | $677.04 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $737.80 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $761.92 | ↑ +46% |
| Highmark BCBS of PA | Commercial | $810.64 | ↑ +56% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +95% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +152% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +152% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +152% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Clsd tx/metatarsal fx without manip 28470 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $551.40 | $82.51 – $827.10 |
| UPMC Carlisle | Carlisle | $520.80 | $107.31 – $1,016.56 |
| UPMC Cole | Coudersport | $693.00 | $51.00 – $340.84 |
| UPMC Community Osteopathic | Harrisburg | $520.80 | $107.31 – $1,016.56 |
| UPMC Hanover | Hanover | $520.80 | $107.31 – $1,016.56 |
| UPMC Lititz | Lititz | $520.80 | $107.31 – $1,016.56 |
| UPMC Magee | Pittsburgh | $748.20 | $92.95 – $376.02 |
| UPMC Muncy | Muncy | $825.60 | $92.95 – $993.28 |