Exc malig feenl 1.1-2 11642 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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$171.45 with Highmark Wholecare (prev Gateway) vs $3,397.00 with Cigna — 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 Wholecare (prev Gateway) | Medicaid | $171.45 | — |
| UPMC Health Plan | Managed Medicaid | $175.50 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $182.25 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $183.87 | — |
| Geisinger | Medicaid/CHIP | $196.64 | — |
| UPMC Work Partners | Workers Comp | $579.13 | — |
| Highmark BCBS of PA | Medicare | $594.82 | — |
| Aetna | Medicare | $703.68 | — |
| Cigna | Medicare | $708.40 | — |
| Geisinger | Medicare | $708.40 | — |
| United Healthcare | Medicare | $721.90 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| Keystone Autism Services | ACAP | $1,079.47 | — |
| Highmark BCBS of PA | Medicaid | $2,234.78 | — |
| UPMC Health Plan | CHIP | $2,297.46 | — |
| Highmark BCBS of PA | Commercial | $2,377.67 | — |
| Capital Blue Cross | CHIP | $2,966.25 | — |
| Keystone Health Plan | Commercial | $2,966.25 | — |
| Capital Blue Cross | Commercial | $2,966.25 | — |
| Cigna | Commercial | $3,397.00 | — |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Exc malig feenl 1.1-2 11642 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,494.00 | $135.00 – $5,992.00 |
| UPMC Cole | Coudersport | $225.00 | $45.74 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $477.00 | $675.75 – $675.75 |
| UPMC Kane | Kane | $658.80 | $148.50 – $1,120.22 |
| UPMC Magee | Pittsburgh | $2,427.00 | $148.50 – $736.75 |
| UPMC Presbyterian | Pittsburgh | $3,835.20 | $148.50 – $931.20 |
| UPMC Somerset | Somerset | $477.00 | $148.50 – $892.40 |
| UPMC St. Margaret | Pittsburgh | $3,448.20 | $148.50 – $736.75 |