Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$43.80
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.
$73.00
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.
$9.58 with United Healthcare Community Plan for Families vs $79.80 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $9.58 | ↓ -78% |
| Prime Net | Managed Medicare | $12.04 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $12.39 | ↓ -72% |
| Aetna | Medicare | $12.50 | ↓ -71% |
| Cigna | Medicare | $12.58 | ↓ -71% |
| Geisinger | Medicare | $12.58 | ↓ -71% |
| United Healthcare | Medicare | $12.82 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $14.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $14.60 | ↓ -67% |
| United Healthcare | Commercial | $18.00 | ↓ -59% |
| Keystone Autism Services | ACAP | $19.17 | ↓ -56% |
| Highmark BCBS of PA | Medicare | $25.62 | ↓ -42% |
| Prime Net | ACO/Legacy Commercial | $29.93 | ↓ -32% |
| Aetna | ACO | $30.15 | ↓ -31% |
| Cigna | Commercial | $31.16 | ↓ -29% |
| Prime Net | GateKeeper/NonGateKeeper | $34.82 | ↓ -21% |
| Aetna | Commercial | $35.04 | ↓ -20% |
| Highmark BCBS of PA | Medicaid | $39.68 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $40.15 | ↓ -8% |
| Highmark BCBS of PA | Commercial | $42.22 | ↓ -4% |
| Geisinger | Commercial | $47.80 | ↑ +9% |
| UPMC Health Plan | Commercial | $51.10 | ↑ +17% |
| Wellspan Population Health | Commercial | $51.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $54.38 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $62.05 | ↑ +42% |
| Capital Blue Cross | CHIP | $79.67 | ↑ +82% |
| Capital Blue Cross | Commercial | $79.67 | ↑ +82% |
| Keystone Health Plan | Commercial | $79.67 | ↑ +82% |
| UPMC Health Plan | CHIP | $79.80 | ↑ +82% |
Visitor-reported prices
Comments
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $151.20 | $11.84 – $201.60 |
| UPMC Bedford | Everett | $72.00 | $4.32 – $108.00 |
| UPMC Carlisle | Carlisle | $43.80 | $6.59 – $62.05 |
| UPMC Cole | Coudersport | $70.20 | $7.79 – $93.60 |
| UPMC Community Osteopathic | Harrisburg | $43.80 | $9.58 – $79.80 |
| UPMC East | Monroeville | $126.00 | $11.84 – $168.00 |
| UPMC Hamot | Erie | $221.40 | $11.84 – $31.43 |
| UPMC Northwest | Seneca | $108.00 | $10.86 – $12.94 |