Oth resp proc, group at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$304.80
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.
$508.00
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.
$7.68 with Highmark BCBS of PA vs $431.80 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare | $7.68 | ↓ -97% |
| United Healthcare Community Plan for Families | PA Medicaid | $27.14 | ↓ -91% |
| Aetna | Medicare | $39.26 | ↓ -87% |
| Geisinger | Medicare | $39.52 | ↓ -87% |
| Cigna | Medicare | $39.52 | ↓ -87% |
| United Healthcare | Medicare | $40.27 | ↓ -87% |
| Keystone Autism Services | ACAP | $60.22 | ↓ -80% |
| UPMC Health Plan | CHIP | $60.54 | ↓ -80% |
| Prime Net | Managed Medicare | $83.82 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $101.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $101.60 | ↓ -67% |
| Highmark BCBS of PA | Medicaid | $124.68 | ↓ -59% |
| Highmark BCBS of PA | Commercial | $132.65 | ↓ -56% |
| United Healthcare | Commercial | $163.00 | ↓ -47% |
| Prime Net | ACO/Legacy Commercial | $208.28 | ↓ -32% |
| Aetna | ACO | $209.80 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $242.32 | ↓ -20% |
| Aetna | Commercial | $243.84 | ↓ -20% |
| Geisinger | Medicaid/CHIP | $279.40 | ↓ -8% |
| Capital Blue Cross | CHIP | $307.54 | ↑ +1% |
| Capital Blue Cross | Commercial | $307.54 | ↑ +1% |
| Keystone Health Plan | Commercial | $322.94 | ↑ +6% |
| Geisinger | Commercial | $332.64 | ↑ +9% |
| Wellspan Population Health | Commercial | $355.60 | ↑ +17% |
| UPMC Health Plan | Commercial | $355.60 | ↑ +17% |
| Prime Net | FH-Medical Rental | $378.46 | ↑ +24% |
| Cigna | Commercial | $387.00 | ↑ +27% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $431.80 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Oth resp proc, group at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $304.80 | $27.14 – $431.80 |
| UPMC Hamot | Erie | $80.40 | $9.42 – $30.77 |
| UPMC Hanover | Hanover | $304.80 | $27.14 – $60.54 |
| UPMC Jameson | New Castle | $58.80 | $9.59 – $46.77 |
| UPMC Lititz | Lititz | $304.80 | $27.14 – $60.54 |
| UPMC McKeesport | Mckeesport | $58.80 | $9.51 – $41.16 |
| UPMC Mercy | Pittsburgh | $38.40 | $9.42 – $47.80 |
| UPMC Passavant-McCandless | Pittsburgh | $72.00 | $9.51 – $41.16 |