Knee orth pos locking joint at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$1,288.20
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.
$2,147.00
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.
$166.69 with Aetna vs $1,824.95 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 |
|---|---|---|---|
| Aetna | Medicare | $166.69 | ↓ -87% |
| United Healthcare Community Plan for Families | PA Medicaid | $242.36 | ↓ -81% |
| Highmark BCBS of PA | Medicare | $350.36 | ↓ -73% |
| Prime Net | Managed Medicare | $354.25 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $429.40 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $429.40 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $459.51 | ↓ -64% |
| Geisinger | Medicaid/CHIP | $708.51 | ↓ -45% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $815.86 | ↓ -37% |
| Prime Net | ACO/Legacy Commercial | $880.27 | ↓ -32% |
| Aetna | ACO | $886.71 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $1,024.12 | ↓ -20% |
| Aetna | Commercial | $1,030.56 | ↓ -20% |
| Capital Blue Cross | Commercial | $1,299.79 | ↑ +1% |
| Capital Blue Cross | CHIP | $1,299.79 | ↑ +1% |
| United Healthcare | Commercial | $1,322.55 | ↑ +3% |
| Keystone Health Plan | Commercial | $1,364.85 | ↑ +6% |
| UPMC Health Plan | CHIP | $1,385.72 | ↑ +8% |
| Geisinger | Commercial | $1,405.86 | ↑ +9% |
| Wellspan Population Health | Commercial | $1,502.90 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,502.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,599.52 | ↑ +24% |
| Cigna | Commercial | $1,674.66 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,824.95 | ↑ +42% |
| Highmark Wholecare (prev Gateway) | Medicaid | not published by hospital | — |
Visitor-reported prices
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Knee orth pos locking joint at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,288.20 | $242.36 – $1,824.95 |
| UPMC Community Osteopathic | Harrisburg | $1,288.20 | $242.36 – $2,262.72 |
| UPMC Hanover | Hanover | $1,288.20 | $242.36 – $1,385.72 |
| UPMC Lititz | Lititz | $1,288.20 | $166.69 – $1,385.72 |
| UPMC Somerset | Somerset | $1,288.20 | $212.76 – $830.00 |