Drainage absc/cyst/hmtma/vestibule mouth smpl at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$924.60
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.
$1,541.00
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 Highmark Wholecare (prev Gateway) vs $2,377.67 with Highmark BCBS of PA — 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 | $33.66 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $33.66 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $34.45 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $36.09 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $38.60 | ↓ -96% |
| Highmark BCBS of PA | Medicare | $106.05 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $184.54 | ↓ -80% |
| Prime Net | Managed Medicare | $254.26 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $308.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $308.20 | ↓ -67% |
| UPMC Health Plan | CHIP | $401.58 | ↓ -57% |
| Prime Net | ACO/Legacy Commercial | $631.81 | ↓ -32% |
| Aetna | ACO | $636.43 | ↓ -31% |
| Aetna | Medicare | $703.68 | ↓ -24% |
| Geisinger | Medicare | $708.40 | ↓ -23% |
| Cigna | Medicare | $708.40 | ↓ -23% |
| United Healthcare | Medicare | $721.90 | ↓ -22% |
| Prime Net | GateKeeper/NonGateKeeper | $735.06 | ↓ -20% |
| Aetna | Commercial | $739.68 | ↓ -20% |
| Geisinger | Commercial | $1,009.05 | ↑ +9% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +10% |
| Wellspan Population Health | Commercial | $1,078.70 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,078.70 | ↑ +17% |
| Keystone Autism Services | ACAP | $1,079.47 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,148.05 | ↑ +24% |
| Cigna | Commercial | $1,201.98 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,309.85 | ↑ +42% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +42% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +42% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $2,234.78 | ↑ +142% |
| Highmark BCBS of PA | Commercial | $2,377.67 | ↑ +157% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Drainage absc/cyst/hmtma/vestibule mouth smpl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $595.20 | $26.50 – $793.60 |
| UPMC Bedford | Everett | $897.00 | $27.82 – $1,345.50 |
| UPMC Carlisle | Carlisle | $924.60 | $33.66 – $1,309.85 |
| UPMC Community Osteopathic | Harrisburg | $924.60 | $33.66 – $1,016.56 |
| UPMC East | Monroeville | $543.60 | $29.15 – $724.80 |
| UPMC Hamot | Erie | $541.20 | $29.15 – $975.61 |
| UPMC Northwest | Seneca | $824.40 | $29.15 – $704.33 |
| UPMC Hanover | Hanover | $924.60 | $33.66 – $1,075.42 |