Clsd tx/scapular fx without manip 23570 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$496.20
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.
$827.00
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.
$92.71 with Highmark Wholecare (prev Gateway) vs $1,731.18 with UPMC Health Plan — 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 | $92.71 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $92.71 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $94.90 | ↓ -81% |
| United Healthcare Community Plan for Families | PA Medicaid | $95.63 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $99.43 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $106.33 | ↓ -79% |
| Prime Net | Managed Medicare | $136.46 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $165.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $165.40 | ↓ -67% |
| Aetna | Medicare | $239.91 | ↓ -52% |
| Cigna | Medicare | $241.52 | ↓ -51% |
| Geisinger | Medicare | $241.52 | ↓ -51% |
| United Healthcare | Medicare | $246.12 | ↓ -50% |
| Prime Net | ACO/Legacy Commercial | $339.07 | ↓ -32% |
| Aetna | ACO | $341.55 | ↓ -31% |
| Keystone Autism Services | ACAP | $368.03 | ↓ -26% |
| UPMC Work Partners | Workers Comp | $386.44 | ↓ -22% |
| Prime Net | GateKeeper/NonGateKeeper | $394.48 | ↓ -20% |
| Aetna | Commercial | $396.96 | ↓ -20% |
| Highmark BCBS of PA | Medicare | $444.23 | ↓ -10% |
| Geisinger | Commercial | $541.52 | ↑ +9% |
| Wellspan Population Health | Commercial | $578.90 | ↑ +17% |
| UPMC Health Plan | Commercial | $578.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $616.12 | ↑ +24% |
| Cigna | Commercial | $645.06 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $702.95 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $761.92 | ↑ +54% |
| Highmark BCBS of PA | Commercial | $810.64 | ↑ +63% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +164% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +164% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +164% |
| UPMC Health Plan | CHIP | $1,731.18 | ↑ +249% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Clsd tx/scapular fx without manip 23570 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $496.20 | $92.71 – $702.95 |
| UPMC Cole | Coudersport | $1,266.00 | $57.93 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $496.20 | $92.71 – $1,731.18 |
| UPMC Hanover | Hanover | $496.20 | $92.71 – $386.44 |
| UPMC Lititz | Lititz | $496.20 | $92.71 – $381.92 |
| UPMC Muncy | Muncy | $825.60 | $80.30 – $421.03 |
| UPMC Somerset | Somerset | $496.20 | $80.30 – $364.94 |
| UPMC Wellsboro | Wellsboro | $998.40 | $80.30 – $364.94 |