Exc im tumor/back/flank/ < 5 cm 21932 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.
$971.99 with Highmark BCBS of PA vs $9,671.88 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 BCBS of PA | Medicare | $971.99 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| UPMC Work Partners | Workers Comp | $1,039.91 | — |
| Aetna | Medicare | $2,862.43 | — |
| Cigna | Medicare | $2,881.64 | — |
| Geisinger | Medicare | $2,881.64 | — |
| United Healthcare | Medicare | $2,936.53 | — |
| Capital Blue Cross | CHIP | $4,172.70 | — |
| Keystone Health Plan | Commercial | $4,172.70 | — |
| Capital Blue Cross | Commercial | $4,172.70 | — |
| Keystone Autism Services | ACAP | $4,391.07 | — |
| UPMC Health Plan | CHIP | $4,456.59 | — |
| Highmark BCBS of PA | Medicaid | $9,090.62 | — |
| Cigna | Commercial | $9,561.00 | — |
| Highmark BCBS of PA | Commercial | $9,671.88 | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Exc im tumor/back/flank/ < 5 cm 21932 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,174.80 | $542.76 – $1,566.40 |
| UPMC St. Margaret | Pittsburgh | $6,814.20 | $993.70 – $3,001.48 |
| Uniontown Hospital | Uniontown | $1,421.50 | $205.80 – $5,847.63 |
| UPMC Altoona | Altoona | not published | $993.70 – $2,946.91 |
| UPMC Carlisle | Carlisle | not published | $1,016.56 – $4,456.59 |
| UPMC Community Osteopathic | Harrisburg | not published | $1,016.56 – $4,456.59 |
| UPMC East | Monroeville | not published | $993.70 – $3,001.48 |
| UPMC Hanover | Hanover | not published | $1,016.56 – $4,456.59 |