Duplex scan bilateral study 93985 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$692.40
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.
$1,154.00
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.
$99.22 with Highmark BCBS of PA vs $1,224.77 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare | $99.22 | ↓ -86% |
| Prime Net | Managed Medicare | $190.41 | ↓ -73% |
| United Healthcare Community Plan for Families | PA Medicaid | $227.90 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $230.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $230.80 | ↓ -67% |
| Aetna | Medicare | $241.76 | ↓ -65% |
| Geisinger | Medicare | $243.38 | ↓ -65% |
| Cigna | Medicare | $243.38 | ↓ -65% |
| United Healthcare | Medicare | $248.02 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $260.65 | ↓ -62% |
| Highmark Wholecare (prev Gateway) | Medicaid | $260.65 | ↓ -62% |
| UPMC Health Plan | Managed Medicaid | $266.81 | ↓ -61% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $279.54 | ↓ -60% |
| Geisinger | Medicaid/CHIP | $298.95 | ↓ -57% |
| Premier Comp Solutions | Worker's Comp | $325.01 | ↓ -53% |
| UPMC Work Partners | Workers Comp | $325.01 | ↓ -53% |
| Keystone Autism Services | ACAP | $370.86 | ↓ -46% |
| Prime Net | ACO/Legacy Commercial | $473.14 | ↓ -32% |
| Aetna | ACO | $476.60 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $550.46 | ↓ -20% |
| Aetna | Commercial | $553.92 | ↓ -20% |
| Capital Blue Cross | CHIP | $698.63 | ↑ +1% |
| Capital Blue Cross | Commercial | $698.63 | ↑ +1% |
| Keystone Health Plan | Commercial | $733.60 | ↑ +6% |
| Geisinger | Commercial | $755.64 | ↑ +9% |
| Highmark BCBS of PA | Medicaid | $767.78 | ↑ +11% |
| United Healthcare | Commercial | $801.00 | ↑ +16% |
| Wellspan Population Health | Commercial | $807.80 | ↑ +17% |
| UPMC Health Plan | CHIP | $807.80 | ↑ +17% |
| UPMC Health Plan | Commercial | $807.80 | ↑ +17% |
| Highmark BCBS of PA | Commercial | $816.87 | ↑ +18% |
| Prime Net | FH-Medical Rental | $859.73 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $980.90 | ↑ +42% |
| Cigna | Commercial | $1,224.77 | ↑ +77% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Duplex scan bilateral study 93985 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $814.20 | $83.15 – $1,221.30 |
| UPMC Carlisle | Carlisle | $692.40 | $158.10 – $980.90 |
| UPMC Community Osteopathic | Harrisburg | $692.40 | $227.90 – $980.90 |
| UPMC East | Monroeville | $791.40 | $122.89 – $1,055.20 |
| UPMC Hamot | Erie | $615.00 | $121.73 – $345.98 |
| UPMC Northwest | Seneca | $1,662.00 | $209.00 – $310.56 |
| UPMC Hanover | Hanover | $692.40 | $227.90 – $369.47 |
| UPMC Horizon-Greenville | Greenville | $1,393.20 | $206.32 – $310.56 |