Incision of hip tendons at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$5,605.80
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.
$9,343.00
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.
$240.03 with Highmark Wholecare (prev Gateway) vs $10,964.70 with Highmark BCBS of PA — 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 | $240.03 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $245.70 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $255.15 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $257.42 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $275.30 | ↓ -95% |
| Highmark BCBS of PA | Medicare | $682.16 | ↓ -88% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $1,431.19 | ↓ -74% |
| Prime Net | Managed Medicare | $1,541.60 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $1,868.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $1,868.60 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,655.13 | ↓ -53% |
| Aetna | Medicare | $3,245.04 | ↓ -42% |
| Cigna | Medicare | $3,266.82 | ↓ -42% |
| Geisinger | Medicare | $3,266.82 | ↓ -42% |
| United Healthcare | Medicare | $3,329.05 | ↓ -41% |
| Prime Net | ACO/Legacy Commercial | $3,830.63 | ↓ -32% |
| Aetna | ACO | $3,858.66 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $4,456.61 | ↓ -21% |
| Aetna | Commercial | $4,484.64 | ↓ -20% |
| Keystone Autism Services | ACAP | $4,978.02 | ↓ -11% |
| Geisinger | Commercial | $6,117.80 | ↑ +9% |
| Wellspan Population Health | Commercial | $6,540.10 | ↑ +17% |
| UPMC Health Plan | Commercial | $6,540.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $6,960.53 | ↑ +24% |
| Capital Blue Cross | Commercial | $7,073.85 | ↑ +26% |
| Capital Blue Cross | CHIP | $7,073.85 | ↑ +26% |
| Keystone Health Plan | Commercial | $7,105.35 | ↑ +27% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $7,941.55 | ↑ +42% |
| Cigna | Commercial | $9,539.00 | ↑ +70% |
| Highmark BCBS of PA | Medicaid | $10,305.74 | ↑ +84% |
| Highmark BCBS of PA | Commercial | $10,964.70 | ↑ +96% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Incision of hip tendons at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $5,605.80 | $240.03 – $7,941.55 |
| UPMC Community Osteopathic | Harrisburg | $5,605.80 | $255.15 – $7,941.55 |
| UPMC Hanover | Hanover | $5,605.80 | $240.03 – $4,959.33 |
| UPMC Lititz | Lititz | $5,605.80 | $240.03 – $4,986.11 |
| UPMC Somerset | Somerset | $5,605.80 | $207.90 – $3,093.35 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | $2,590.40 | $236.25 – $642.60 |