Clsd tx wrist trans-scaph fx w/manip 25680 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$597.60
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.
$996.00
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.
$164.34 with Prime Net vs $2,316.94 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $164.34 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $199.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $199.20 | ↓ -67% |
| Aetna | Medicare | $239.91 | ↓ -60% |
| Geisinger | Medicare | $241.52 | ↓ -60% |
| Cigna | Medicare | $241.52 | ↓ -60% |
| United Healthcare | Medicare | $246.12 | ↓ -59% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $284.48 | ↓ -52% |
| Highmark Wholecare (prev Gateway) | Medicaid | $284.48 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $291.20 | ↓ -51% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $305.09 | ↓ -49% |
| Geisinger | Medicaid/CHIP | $326.28 | ↓ -45% |
| Keystone Autism Services | ACAP | $368.03 | ↓ -38% |
| Prime Net | ACO/Legacy Commercial | $408.36 | ↓ -32% |
| Aetna | ACO | $411.35 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $475.09 | ↓ -21% |
| Aetna | Commercial | $478.08 | ↓ -20% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -0% |
| Geisinger | Commercial | $652.18 | ↑ +9% |
| Wellspan Population Health | Commercial | $697.20 | ↑ +17% |
| UPMC Health Plan | Commercial | $697.20 | ↑ +17% |
| Prime Net | FH-Medical Rental | $742.02 | ↑ +24% |
| Highmark BCBS of PA | Medicaid | $761.92 | ↑ +27% |
| Cigna | Commercial | $776.88 | ↑ +30% |
| UPMC Work Partners | Workers Comp | $809.29 | ↑ +35% |
| Highmark BCBS of PA | Commercial | $810.64 | ↑ +36% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $846.60 | ↑ +42% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +70% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +119% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +119% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +119% |
| UPMC Health Plan | CHIP | $2,316.94 | ↑ +288% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Clsd tx wrist trans-scaph fx w/manip 25680 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $597.60 | $136.45 – $1,016.56 |
| UPMC Community Osteopathic | Harrisburg | $597.60 | $199.20 – $2,316.94 |
| UPMC Hanover | Hanover | $597.60 | $226.87 – $1,016.56 |
| UPMC Jameson | New Castle | $3,391.80 | $228.70 – $892.40 |
| UPMC Lititz | Lititz | $597.60 | $228.10 – $1,016.56 |
| UPMC Mercy | Pittsburgh | $3,331.80 | $190.64 – $824.16 |
| UPMC Somerset | Somerset | $597.60 | $226.41 – $892.40 |
| UPMC Presbyterian | Pittsburgh | not published | $246.40 – $958.33 |