Observation direct referral from physician office for admission at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$420.00
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.
$700.00
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.
$115.50 with Prime Net vs $3,614.86 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $115.50 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $140.00 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $140.00 | ↓ -67% |
| Prime Net | ACO/Legacy Commercial | $287.00 | ↓ -32% |
| Aetna | ACO | $289.10 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $333.90 | ↓ -21% |
| Aetna | Commercial | $336.00 | ↓ -20% |
| Geisinger | Commercial | $458.36 | ↑ +9% |
| Wellspan Population Health | Commercial | $490.00 | ↑ +17% |
| Cigna | Commercial | $513.10 | ↑ +22% |
| Prime Net | FH-Medical Rental | $521.50 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $595.00 | ↑ +42% |
| Aetna | Medicare | $613.18 | ↑ +46% |
| Cigna | Medicare | $617.29 | ↑ +47% |
| Geisinger | Medicare | $617.29 | ↑ +47% |
| United Healthcare | Medicare | $629.05 | ↑ +50% |
| Keystone Autism Services | ACAP | $940.64 | ↑ +124% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1,300.00 | ↑ +210% |
| UPMC Health Plan | Managed Medicaid | $1,500.00 | ↑ +257% |
| Highmark BCBS of PA | Medicaid | $1,947.36 | ↑ +364% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $2,064.00 | ↑ +391% |
| Highmark BCBS of PA | Commercial | $2,071.88 | ↑ +393% |
| Geisinger | Medicaid/CHIP | $2,207.16 | ↑ +426% |
| UPMC Health Plan | CHIP | $3,000.00 | ↑ +614% |
| Capital Blue Cross | Commercial | $3,068.10 | ↑ +631% |
| Keystone Health Plan | Commercial | $3,068.10 | ↑ +631% |
| Capital Blue Cross | CHIP | $3,068.10 | ↑ +631% |
| UPMC Health Plan | Commercial | $3,614.86 | ↑ +761% |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $117.00 | $27.00 – $2,064.00 |
| UPMC Bedford | Everett | $166.20 | $31.88 – $2,207.16 |
| UPMC Carlisle | Carlisle | $420.00 | $95.90 – $2,064.00 |
| UPMC Cole | Coudersport | $84.00 | $38.81 – $112.00 |
| UPMC Community Osteopathic | Harrisburg | $420.00 | $169.40 – $3,000.00 |
| UPMC East | Monroeville | $130.20 | $31.88 – $2,207.16 |
| UPMC Hamot | Erie | $138.60 | $674.61 – $728.58 |
| UPMC Northwest | Seneca | $112.80 | $31.88 – $631.28 |