Ercp lithotripsy calculi at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$7,247.40
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.
?
What you pay up front if you don't use insurance.
$12,079.00
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.
$594.82 with Highmark BCBS of PA vs $20,116.66 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 BCBS of PA | Medicare | $594.82 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $1,450.22 | ↓ -80% |
| Prime Net | Managed Medicare | $1,993.04 | ↓ -72% |
| UPMC Health Plan | CHIP | $2,297.29 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $2,415.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,415.80 | ↓ -67% |
| Prime Net | ACO/Legacy Commercial | $4,952.39 | ↓ -32% |
| Aetna | ACO | $4,988.63 | ↓ -31% |
| Cigna | Commercial | $5,035.00 | ↓ -31% |
| Keystone Health Plan | Commercial | $5,588.10 | ↓ -23% |
| Capital Blue Cross | CHIP | $5,588.10 | ↓ -23% |
| Capital Blue Cross | Commercial | $5,588.10 | ↓ -23% |
| Prime Net | GateKeeper/NonGateKeeper | $5,761.68 | ↓ -21% |
| Aetna | Commercial | $5,797.92 | ↓ -20% |
| Aetna | Medicare | $5,953.60 | ↓ -18% |
| Cigna | Medicare | $5,993.56 | ↓ -17% |
| Geisinger | Medicare | $5,993.56 | ↓ -17% |
| United Healthcare | Medicare | $6,107.72 | ↓ -16% |
| Geisinger | Medicaid/CHIP | $6,643.45 | ↓ -8% |
| Geisinger | Commercial | $7,909.33 | ↑ +9% |
| Wellspan Population Health | Commercial | $8,455.30 | ↑ +17% |
| UPMC Health Plan | Commercial | $8,455.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $8,998.85 | ↑ +24% |
| Keystone Autism Services | ACAP | $9,133.04 | ↑ +26% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $10,267.15 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $18,907.68 | ↑ +161% |
| Highmark BCBS of PA | Commercial | $20,116.66 | ↑ +178% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Ercp lithotripsy calculi at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,517.80 | $729.80 – $6,129.31 |
| UPMC Carlisle | Carlisle | $7,247.40 | $1,016.56 – $10,267.15 |
| UPMC Community Osteopathic | Harrisburg | $7,247.40 | $1,016.56 – $10,267.15 |
| UPMC East | Monroeville | $3,435.60 | $736.75 – $6,129.31 |
| UPMC Hamot | Erie | $4,144.80 | $729.80 – $8,254.31 |
| UPMC Hanover | Hanover | $7,247.40 | $1,016.56 – $9,098.75 |
| UPMC Jameson | New Castle | $2,490.00 | $742.68 – $7,661.64 |
| UPMC Lititz | Lititz | $7,247.40 | $1,016.56 – $9,147.90 |