Fna bx w/mr gdn ea addl at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$296.40
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.
$494.00
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.
$62.01 with Highmark BCBS of PA vs $419.90 with Multiplan — 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 | $62.01 | ↓ -79% |
| Prime Net | Managed Medicare | $81.51 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $98.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $98.80 | ↓ -67% |
| Aetna | Medicare | $162.07 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicaid | $166.76 | ↓ -44% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $166.76 | ↓ -44% |
| UPMC Health Plan | Managed Medicaid | $170.70 | ↓ -42% |
| United Healthcare Community Plan for Families | PA Medicaid | $172.02 | ↓ -42% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $178.84 | ↓ -40% |
| Geisinger | Medicaid/CHIP | $191.27 | ↓ -35% |
| Prime Net | ACO/Legacy Commercial | $202.54 | ↓ -32% |
| Aetna | ACO | $204.02 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $235.64 | ↓ -20% |
| Aetna | Commercial | $237.12 | ↓ -20% |
| Capital Blue Cross | Commercial | $299.07 | ↑ +1% |
| Capital Blue Cross | CHIP | $299.07 | ↑ +1% |
| Keystone Health Plan | Commercial | $314.04 | ↑ +6% |
| Geisinger | Commercial | $323.47 | ↑ +9% |
| Wellspan Population Health | Commercial | $345.80 | ↑ +17% |
| UPMC Health Plan | CHIP | $345.80 | ↑ +17% |
| UPMC Health Plan | Commercial | $345.80 | ↑ +17% |
| United Healthcare | Commercial | $363.58 | ↑ +23% |
| Prime Net | FH-Medical Rental | $368.03 | ↑ +24% |
| Cigna | Commercial | $385.32 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $419.90 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Fna bx w/mr gdn ea addl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $296.40 | $67.68 – $419.90 |
| UPMC Community Osteopathic | Harrisburg | $296.40 | $98.80 – $419.90 |
| UPMC East | Monroeville | $570.60 | $76.81 – $760.80 |
| UPMC Hanover | Hanover | $296.40 | $166.76 – $223.78 |
| UPMC Lititz | Lititz | $296.40 | $162.07 – $191.27 |
| UPMC Magee | Pittsburgh | $760.80 | $76.81 – $223.78 |
| UPMC Passavant-McCandless | Pittsburgh | $575.40 | $76.81 – $223.78 |
| UPMC Somerset | Somerset | $296.40 | $75.31 – $182.51 |