Ex sq tumor/face or scalp 2 cm/> 21012 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
not published by hospital
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.
not published by hospital
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.
$329.92 with Highmark Wholecare (prev Gateway) vs $5,475.37 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 | $329.92 | — |
| UPMC Health Plan | Managed Medicaid | $337.71 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $350.70 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $353.82 | — |
| Geisinger | Medicaid/CHIP | $378.40 | — |
| Highmark BCBS of PA | Medicare | $480.63 | — |
| UPMC Work Partners | Workers Comp | $514.22 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| Aetna | Medicare | $1,620.46 | — |
| Geisinger | Medicare | $1,631.33 | — |
| Cigna | Medicare | $1,631.33 | — |
| United Healthcare | Medicare | $1,662.41 | — |
| Keystone Autism Services | ACAP | $2,485.84 | — |
| Capital Blue Cross | CHIP | $2,966.25 | — |
| Capital Blue Cross | Commercial | $2,966.25 | — |
| Keystone Health Plan | Commercial | $2,966.25 | — |
| UPMC Health Plan | CHIP | $3,581.26 | — |
| Cigna | Commercial | $5,035.00 | — |
| Highmark BCBS of PA | Medicaid | $5,146.31 | — |
| Highmark BCBS of PA | Commercial | $5,475.37 | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Ex sq tumor/face or scalp 2 cm/> 21012 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $581.40 | $268.61 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $877.20 | $350.70 – $3,581.26 |
| UPMC Somerset | Somerset | $877.20 | $285.76 – $1,544.70 |
| UPMC St. Margaret | Pittsburgh | $3,369.60 | $285.76 – $1,699.17 |
| Uniontown Hospital | Uniontown | $1,898.50 | $205.80 – $3,324.90 |
| UPMC East | Monroeville | not published | $285.76 – $1,699.17 |
| UPMC Kane | Kane | not published | $285.76 – $1,431.92 |
| UPMC Mercy | Pittsburgh | not published | $285.76 – $1,699.17 |