Oral everolimus at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$6.00
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.
$10.00
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.
$0.66 with Prime Net vs $4.73 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $0.66 | ↓ -89% |
| Keystone Health Plan | Medicare Advantage | $0.80 | ↓ -87% |
| Capital Blue Cross | Medicare Advantage | $0.80 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $1.37 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1.37 | ↓ -77% |
| Aetna | Medicare | $1.38 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1.40 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $1.44 | ↓ -76% |
| UPMC Health Plan | Managed Medicaid | $1.51 | ↓ -75% |
| Capital Blue Cross | Commercial | $1.62 | ↓ -73% |
| Capital Blue Cross | CHIP | $1.62 | ↓ -73% |
| Prime Net | ACO/Legacy Commercial | $1.64 | ↓ -73% |
| Aetna | ACO | $1.65 | ↓ -73% |
| UPMC Health Plan | CHIP | $1.69 | ↓ -72% |
| Prime Net | GateKeeper/NonGateKeeper | $1.91 | ↓ -68% |
| Aetna | Commercial | $1.92 | ↓ -68% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $2.17 | ↓ -64% |
| United Healthcare | Commercial | $2.46 | ↓ -59% |
| Geisinger | Commercial | $2.62 | ↓ -56% |
| Wellspan Population Health | Commercial | $2.80 | ↓ -53% |
| UPMC Health Plan | Commercial | $2.80 | ↓ -53% |
| Keystone Health Plan | Commercial | $2.88 | ↓ -52% |
| Prime Net | FH-Medical Rental | $2.98 | ↓ -50% |
| Cigna | Commercial | $3.12 | ↓ -48% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3.40 | ↓ -43% |
| Highmark BCBS of PA | Medicare | $4.73 | ↓ -21% |
Visitor-reported prices
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Oral everolimus at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $6.00 | $0.55 – $3.40 |
| UPMC Community Osteopathic | Harrisburg | $6.00 | $0.80 – $9.66 |
| UPMC Hanover | Hanover | $6.00 | $1.37 – $2.17 |
| UPMC Lititz | Lititz | $6.00 | $1.37 – $2.17 |
| UPMC Muncy | Muncy | $115.20 | $1.37 – $1.51 |
| UPMC Somerset | Somerset | $6.00 | $1.37 – $5.74 |
| UPMC Wellsboro | Wellsboro | $115.20 | $1.37 – $1.51 |
| UPMC Western Psychiatric | Pittsburgh | $30.30 | $1.37 – $5.74 |