Drain finger abscess;simple 26010 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$265.20
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.
$442.00
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.
$33.66 with AmeriHealth Caritas 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $33.66 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $33.66 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $34.45 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $36.09 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $38.60 | ↓ -85% |
| Highmark BCBS of PA | Medicare | $53.12 | ↓ -80% |
| Prime Net | Managed Medicare | $72.93 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $88.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $88.40 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $162.55 | ↓ -39% |
| Prime Net | ACO/Legacy Commercial | $181.22 | ↓ -32% |
| Aetna | ACO | $182.55 | ↓ -31% |
| Aetna | Medicare | $198.72 | ↓ -25% |
| Geisinger | Medicare | $200.06 | ↓ -25% |
| Cigna | Medicare | $200.06 | ↓ -25% |
| United Healthcare | Medicare | $203.87 | ↓ -23% |
| Prime Net | GateKeeper/NonGateKeeper | $210.83 | ↓ -21% |
| Aetna | Commercial | $212.16 | ↓ -20% |
| UPMC Health Plan | CHIP | $212.97 | ↓ -20% |
| Geisinger | Commercial | $289.42 | ↑ +9% |
| Keystone Autism Services | ACAP | $304.85 | ↑ +15% |
| Wellspan Population Health | Commercial | $309.40 | ↑ +17% |
| UPMC Health Plan | Commercial | $309.40 | ↑ +17% |
| Prime Net | FH-Medical Rental | $329.29 | ↑ +24% |
| Cigna | Commercial | $344.76 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $375.70 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $631.11 | ↑ +138% |
| Highmark BCBS of PA | Commercial | $671.47 | ↑ +153% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +283% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +394% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +394% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +394% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Drain finger abscess;simple 26010 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $366.00 | $26.50 – $488.00 |
| UPMC Bedford | Everett | $459.60 | $27.82 – $689.40 |
| UPMC Carlisle | Carlisle | $265.20 | $33.66 – $1,016.56 |
| UPMC Cole | Coudersport | $823.20 | $27.82 – $332.00 |
| UPMC Community Osteopathic | Harrisburg | $265.20 | $33.66 – $1,016.56 |
| UPMC East | Monroeville | $272.40 | $29.15 – $363.20 |
| UPMC Hamot | Erie | $288.00 | $29.15 – $275.52 |
| UPMC Northwest | Seneca | $194.40 | $29.15 – $198.91 |