Drain neck/chest lesion 21501 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$5,874.00
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.
?
What you pay up front if you don't use insurance.
$9,790.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$112.39 with Highmark Wholecare (prev Gateway) vs $9,671.88 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $112.39 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $115.05 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $119.47 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $120.54 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $128.91 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $536.87 | ↓ -91% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -90% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -83% |
| Prime Net | Managed Medicare | $1,615.35 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $1,958.00 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,958.00 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,314.82 | ↓ -61% |
| Aetna | Medicare | $2,862.43 | ↓ -51% |
| Cigna | Medicare | $2,881.64 | ↓ -51% |
| Geisinger | Medicare | $2,881.64 | ↓ -51% |
| United Healthcare | Medicare | $2,936.53 | ↓ -50% |
| Prime Net | ACO/Legacy Commercial | $4,013.90 | ↓ -32% |
| Aetna | ACO | $4,043.27 | ↓ -31% |
| Keystone Autism Services | ACAP | $4,391.07 | ↓ -25% |
| Prime Net | GateKeeper/NonGateKeeper | $4,669.83 | ↓ -21% |
| Aetna | Commercial | $4,699.20 | ↓ -20% |
| Cigna | Commercial | $5,035.00 | ↓ -14% |
| Capital Blue Cross | Commercial | $5,588.10 | ↓ -5% |
| Capital Blue Cross | CHIP | $5,588.10 | ↓ -5% |
| Keystone Health Plan | Commercial | $5,588.10 | ↓ -5% |
| Geisinger | Commercial | $6,410.49 | ↑ +9% |
| Wellspan Population Health | Commercial | $6,853.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $6,853.00 | ↑ +17% |
| Prime Net | FH-Medical Rental | $7,293.55 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $8,321.50 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $9,090.62 | ↑ +55% |
| Highmark BCBS of PA | Commercial | $9,671.88 | ↑ +65% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Drain neck/chest lesion 21501 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $5,874.00 | $112.39 – $8,321.50 |
| UPMC Community Osteopathic | Harrisburg | $5,874.00 | $119.47 – $8,321.50 |
| UPMC Hanover | Hanover | $5,874.00 | $112.39 – $4,374.59 |
| UPMC Lititz | Lititz | $5,874.00 | $112.39 – $4,398.21 |
| UPMC Passavant-McCandless | Pittsburgh | $3,347.40 | $97.35 – $3,001.48 |
| UPMC Somerset | Somerset | $5,874.00 | $97.35 – $2,728.62 |
| Uniontown Hospital | Uniontown | $3,338.50 | $97.35 – $5,847.63 |
| UPMC Altoona | Altoona | not published | $88.50 – $2,946.91 |