Ghs tx distal phalangeal fx with manipulation at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$415.80
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.
$693.00
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.
$92.71 with AmeriHealth Caritas vs $1,310.40 with Capital Blue Cross — 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 | $92.71 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $92.71 | ↓ -78% |
| UPMC Health Plan | Managed Medicaid | $94.90 | ↓ -77% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $99.43 | ↓ -76% |
| Highmark BCBS of PA | Medicare | $106.05 | ↓ -74% |
| Geisinger | Medicaid/CHIP | $106.33 | ↓ -74% |
| Prime Net | Managed Medicare | $114.34 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $138.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $138.60 | ↓ -67% |
| Aetna | Medicare | $239.91 | ↓ -42% |
| Geisinger | Medicare | $241.52 | ↓ -42% |
| Cigna | Medicare | $241.52 | ↓ -42% |
| United Healthcare | Medicare | $246.12 | ↓ -41% |
| Prime Net | ACO/Legacy Commercial | $284.13 | ↓ -32% |
| Aetna | ACO | $286.21 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $330.56 | ↓ -21% |
| Aetna | Commercial | $332.64 | ↓ -20% |
| UPMC Work Partners | Workers Comp | $362.63 | ↓ -13% |
| Keystone Autism Services | ACAP | $368.03 | ↓ -11% |
| UPMC Health Plan | CHIP | $400.40 | ↓ -4% |
| Geisinger | Commercial | $453.78 | ↑ +9% |
| UPMC Health Plan | Commercial | $485.10 | ↑ +17% |
| Wellspan Population Health | Commercial | $485.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $516.28 | ↑ +24% |
| Cigna | Commercial | $540.54 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $589.05 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $761.92 | ↑ +83% |
| Highmark BCBS of PA | Commercial | $810.64 | ↑ +95% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +144% |
| Keystone Health Plan | Commercial | $1,310.40 | ↑ +215% |
| Capital Blue Cross | Commercial | $1,310.40 | ↑ +215% |
| Capital Blue Cross | CHIP | $1,310.40 | ↑ +215% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Ghs tx distal phalangeal fx with manipulation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $574.80 | $73.00 – $766.40 |
| UPMC Bedford | Everett | $722.40 | $76.65 – $1,083.60 |
| UPMC Carlisle | Carlisle | $415.80 | $92.71 – $1,016.56 |
| UPMC Cole | Coudersport | $988.80 | $76.65 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $415.80 | $92.71 – $1,016.56 |
| UPMC Hamot | Erie | $539.40 | $80.30 – $361.27 |
| UPMC Northwest | Seneca | $824.40 | $80.30 – $346.51 |
| UPMC Hanover | Hanover | $415.80 | $92.71 – $1,016.56 |