Exchange biliary drg cath at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$7,502.40
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.
$12,504.00
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.
$152.63 with Highmark Wholecare (prev Gateway) vs $16,693.00 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 Wholecare (prev Gateway) | Medicaid | $152.63 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $156.23 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $162.24 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $163.69 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $175.05 | ↓ -98% |
| Highmark BCBS of PA | Medicare | $443.99 | ↓ -94% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $1,091.86 | ↓ -85% |
| Prime Net | Managed Medicare | $2,063.16 | ↓ -73% |
| UPMC Health Plan | CHIP | $2,071.33 | ↓ -72% |
| Capital Blue Cross | Medicare Advantage | $2,500.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $2,500.80 | ↓ -67% |
| Aetna | Medicare | $3,529.53 | ↓ -53% |
| Geisinger | Medicare | $3,553.22 | ↓ -53% |
| Cigna | Medicare | $3,553.22 | ↓ -53% |
| United Healthcare | Medicare | $3,620.90 | ↓ -52% |
| Prime Net | ACO/Legacy Commercial | $5,126.64 | ↓ -32% |
| Aetna | ACO | $5,164.15 | ↓ -31% |
| Keystone Autism Services | ACAP | $5,414.43 | ↓ -28% |
| Prime Net | GateKeeper/NonGateKeeper | $5,964.41 | ↓ -20% |
| Aetna | Commercial | $6,001.92 | ↓ -20% |
| Capital Blue Cross | CHIP | $7,073.85 | ↓ -6% |
| Capital Blue Cross | Commercial | $7,073.85 | ↓ -6% |
| Keystone Health Plan | Commercial | $7,105.35 | ↓ -5% |
| Geisinger | Commercial | $8,187.62 | ↑ +9% |
| Wellspan Population Health | Commercial | $8,752.80 | ↑ +17% |
| UPMC Health Plan | Commercial | $8,752.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $9,315.48 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $10,628.40 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $11,209.23 | ↑ +49% |
| Highmark BCBS of PA | Commercial | $11,925.96 | ↑ +59% |
| Cigna | Commercial | $16,693.00 | ↑ +123% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Exchange biliary drg cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,273.40 | $120.18 – $3,031.20 |
| UPMC Carlisle | Carlisle | $7,502.40 | $152.63 – $10,628.40 |
| UPMC Community Osteopathic | Harrisburg | $7,502.40 | $162.24 – $10,628.40 |
| UPMC East | Monroeville | $3,058.80 | $132.20 – $4,078.40 |
| UPMC Hamot | Erie | $3,045.00 | $132.20 – $4,893.48 |
| UPMC Northwest | Seneca | $3,855.00 | $132.20 – $3,532.77 |
| UPMC Hanover | Hanover | $7,502.40 | $152.63 – $5,394.10 |
| UPMC Jameson | New Castle | $2,373.00 | $132.20 – $4,542.13 |