Incision of hip tendon at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$4,284.60
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.
$7,141.00
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.
$150.50 with Highmark Wholecare (prev Gateway) vs $6,069.85 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 Wholecare (prev Gateway) | Medicaid | $150.50 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $154.05 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $159.97 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $161.40 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $172.61 | ↓ -96% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $707.79 | ↓ -83% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -76% |
| Prime Net | Managed Medicare | $1,178.27 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $1,428.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,428.20 | ↓ -67% |
| Aetna | Medicare | $1,600.62 | ↓ -63% |
| Cigna | Medicare | $1,611.36 | ↓ -62% |
| Geisinger | Medicare | $1,611.36 | ↓ -62% |
| United Healthcare | Medicare | $1,642.05 | ↓ -62% |
| UPMC Health Plan | CHIP | $2,299.14 | ↓ -46% |
| Keystone Autism Services | ACAP | $2,455.41 | ↓ -43% |
| Prime Net | ACO/Legacy Commercial | $2,927.81 | ↓ -32% |
| Aetna | ACO | $2,949.23 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $3,406.26 | ↓ -20% |
| Aetna | Commercial | $3,427.68 | ↓ -20% |
| Geisinger | Commercial | $4,675.93 | ↑ +9% |
| Wellspan Population Health | Commercial | $4,998.70 | ↑ +17% |
| UPMC Health Plan | Commercial | $4,998.70 | ↑ +17% |
| Cigna | Commercial | $5,035.00 | ↑ +18% |
| Highmark BCBS of PA | Medicaid | $5,083.31 | ↑ +19% |
| Prime Net | FH-Medical Rental | $5,320.05 | ↑ +24% |
| Highmark BCBS of PA | Commercial | $5,408.34 | ↑ +26% |
| Keystone Health Plan | Commercial | $5,588.10 | ↑ +30% |
| Capital Blue Cross | Commercial | $5,588.10 | ↑ +30% |
| Capital Blue Cross | CHIP | $5,588.10 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $6,069.85 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Incision of hip tendon at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,284.60 | $150.50 – $6,069.85 |
| UPMC Cole | Coudersport | $792.60 | $124.42 – $1,056.80 |
| UPMC Community Osteopathic | Harrisburg | $4,284.60 | $159.97 – $6,069.85 |
| UPMC Hanover | Hanover | $4,284.60 | $150.50 – $2,446.19 |
| UPMC Lititz | Lititz | $4,284.60 | $150.50 – $2,459.41 |
| UPMC Somerset | Somerset | $4,284.60 | $130.35 – $1,525.80 |