Diagnostic radio unlisted proc at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$170.40
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.
$284.00
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.
$46.86 with Prime Net vs $419.44 with Cigna — 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 | $46.86 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $56.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $56.80 | ↓ -67% |
| UPMC Health Plan | CHIP | $64.74 | ↓ -62% |
| United Healthcare Community Plan for Families | PA Medicaid | $69.43 | ↓ -59% |
| Aetna | Medicare | $88.06 | ↓ -48% |
| Geisinger | Medicare | $88.65 | ↓ -48% |
| Cigna | Medicare | $88.65 | ↓ -48% |
| United Healthcare | Medicare | $90.34 | ↓ -47% |
| Prime Net | ACO/Legacy Commercial | $116.44 | ↓ -32% |
| Aetna | ACO | $117.29 | ↓ -31% |
| Keystone Autism Services | ACAP | $135.09 | ↓ -21% |
| Prime Net | GateKeeper/NonGateKeeper | $135.47 | ↓ -20% |
| Aetna | Commercial | $136.32 | ↓ -20% |
| Highmark BCBS of PA | Medicare | $140.58 | ↓ -18% |
| Geisinger | Medicaid/CHIP | $156.20 | ↓ -8% |
| Capital Blue Cross | Commercial | $171.93 | ↑ +1% |
| Capital Blue Cross | CHIP | $171.93 | ↑ +1% |
| Keystone Health Plan | Commercial | $180.54 | ↑ +6% |
| Geisinger | Commercial | $185.96 | ↑ +9% |
| UPMC Health Plan | Commercial | $198.80 | ↑ +17% |
| Wellspan Population Health | Commercial | $198.80 | ↑ +17% |
| United Healthcare | Commercial | $209.02 | ↑ +23% |
| Prime Net | FH-Medical Rental | $211.58 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $241.40 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $279.67 | ↑ +64% |
| Highmark BCBS of PA | Commercial | $297.55 | ↑ +75% |
| Cigna | Commercial | $419.44 | ↑ +146% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Diagnostic radio unlisted proc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $255.00 | $64.74 – $340.00 |
| UPMC Carlisle | Carlisle | $170.40 | $38.91 – $241.40 |
| UPMC Community Osteopathic | Harrisburg | $170.40 | $56.80 – $241.40 |
| UPMC Hanover | Hanover | $170.40 | $64.74 – $134.58 |
| UPMC Kane | Kane | $264.00 | $47.67 – $47.67 |
| UPMC Lititz | Lititz | $170.40 | $64.74 – $135.31 |
| UPMC Magee | Pittsburgh | $2,070.60 | $18.84 – $92.34 |
| UPMC Presbyterian | Pittsburgh | $686.40 | $63.60 – $92.34 |