Perq plmt bile duct stent at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$7,327.20
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.
$12,212.00
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.
$550.52 with Highmark Wholecare (prev Gateway) vs $19,716.38 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $550.52 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $563.52 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $585.20 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $590.40 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $631.41 | ↓ -91% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -86% |
| Prime Net | Managed Medicare | $2,014.98 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $2,442.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,442.40 | ↓ -67% |
| Highmark BCBS of PA | Medicare | $2,772.33 | ↓ -62% |
| Prime Net | ACO/Legacy Commercial | $5,006.92 | ↓ -32% |
| Aetna | ACO | $5,043.56 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $5,825.12 | ↓ -21% |
| Aetna | Medicare | $5,835.14 | ↓ -20% |
| Aetna | Commercial | $5,861.76 | ↓ -20% |
| Geisinger | Medicare | $5,874.30 | ↓ -20% |
| Cigna | Medicare | $5,874.30 | ↓ -20% |
| United Healthcare | Medicare | $5,986.19 | ↓ -18% |
| UPMC Work Partners | Workers Comp | $6,817.84 | ↓ -7% |
| Geisinger | Commercial | $7,996.42 | ↑ +9% |
| Wellspan Population Health | Commercial | $8,548.40 | ↑ +17% |
| UPMC Health Plan | CHIP | $8,548.40 | ↑ +17% |
| UPMC Health Plan | Commercial | $8,548.40 | ↑ +17% |
| Keystone Autism Services | ACAP | $8,951.31 | ↑ +22% |
| Prime Net | FH-Medical Rental | $9,097.94 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $10,380.20 | ↑ +42% |
| Keystone Health Plan | Commercial | $10,518.90 | ↑ +44% |
| Capital Blue Cross | Commercial | $10,518.90 | ↑ +44% |
| Capital Blue Cross | CHIP | $10,518.90 | ↑ +44% |
| Cigna | Commercial | $16,693.00 | ↑ +128% |
| Highmark BCBS of PA | Medicaid | $18,531.45 | ↑ +153% |
| Highmark BCBS of PA | Commercial | $19,716.38 | ↑ +169% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Perq plmt bile duct stent at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $7,327.20 | $550.52 – $10,380.20 |
| UPMC Community Osteopathic | Harrisburg | $7,327.20 | $585.20 – $10,380.20 |
| UPMC East | Monroeville | $13,188.60 | $476.83 – $17,584.80 |
| UPMC Hamot | Erie | $8,767.80 | $476.83 – $8,090.06 |
| UPMC Hanover | Hanover | $7,327.20 | $550.52 – $8,917.70 |
| UPMC Lititz | Lititz | $7,327.20 | $550.52 – $8,965.87 |
| UPMC Passavant-McCandless | Pittsburgh | $20,091.00 | $476.83 – $7,575.38 |
| UPMC Presbyterian | Pittsburgh | $24,852.00 | $476.83 – $8,780.18 |