Ghs simple repair 12.6 - 20.0 cm - 12005 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$819.60
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.
$1,366.00
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.
$116.84 with AmeriHealth Caritas vs $2,297.06 with UPMC Health Plan — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $116.84 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $116.84 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $119.60 | ↓ -85% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $125.30 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $134.01 | ↓ -84% |
| Prime Net | Managed Medicare | $225.39 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $273.20 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $273.20 | ↓ -67% |
| Aetna | Medicare | $399.58 | ↓ -51% |
| Cigna | Medicare | $402.27 | ↓ -51% |
| Geisinger | Medicare | $402.27 | ↓ -51% |
| United Healthcare | Medicare | $409.93 | ↓ -50% |
| UPMC Work Partners | Workers Comp | $439.46 | ↓ -46% |
| Prime Net | ACO/Legacy Commercial | $560.06 | ↓ -32% |
| Aetna | ACO | $564.16 | ↓ -31% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -27% |
| Keystone Autism Services | ACAP | $612.98 | ↓ -25% |
| Prime Net | GateKeeper/NonGateKeeper | $651.58 | ↓ -21% |
| Aetna | Commercial | $655.68 | ↓ -20% |
| Geisinger | Commercial | $894.46 | ↑ +9% |
| UPMC Health Plan | Commercial | $956.20 | ↑ +17% |
| Wellspan Population Health | Commercial | $956.20 | ↑ +17% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +24% |
| Prime Net | FH-Medical Rental | $1,017.67 | ↑ +24% |
| Cigna | Commercial | $1,065.48 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,161.10 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $1,269.01 | ↑ +55% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +60% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +60% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +60% |
| Highmark BCBS of PA | Commercial | $1,350.16 | ↑ +65% |
| UPMC Health Plan | CHIP | $2,297.06 | ↑ +180% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 12.6 - 20.0 cm - 12005 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,305.00 | $92.00 – $1,740.00 |
| UPMC Bedford | Everett | $1,626.60 | $96.60 – $2,439.90 |
| UPMC Carlisle | Carlisle | $819.60 | $116.84 – $1,161.10 |
| UPMC Cole | Coudersport | $1,693.20 | $96.60 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $819.60 | $116.84 – $2,297.06 |
| UPMC East | Monroeville | $3,055.20 | $101.20 – $4,073.60 |
| UPMC Hamot | Erie | $3,097.80 | $101.20 – $729.80 |
| UPMC Northwest | Seneca | $2,183.40 | $101.20 – $419.93 |