Proctosigmoidoscopy dx 45300 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$1,420.20
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.
$2,367.00
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.
$30.95 with Highmark Wholecare (prev Gateway) vs $3,397.00 with Cigna — 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 | $30.95 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $31.68 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $32.90 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $33.19 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $35.50 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $126.05 | ↓ -91% |
| Highmark BCBS of PA | Medicare | $272.70 | ↓ -81% |
| Prime Net | Managed Medicare | $390.56 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $473.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $473.40 | ↓ -67% |
| Aetna | Medicare | $911.83 | ↓ -36% |
| Geisinger | Medicare | $917.95 | ↓ -35% |
| Cigna | Medicare | $917.95 | ↓ -35% |
| United Healthcare | Medicare | $935.44 | ↓ -34% |
| Prime Net | ACO/Legacy Commercial | $970.47 | ↓ -32% |
| Aetna | ACO | $977.57 | ↓ -31% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -28% |
| UPMC Health Plan | CHIP | $1,064.56 | ↓ -25% |
| Prime Net | GateKeeper/NonGateKeeper | $1,129.06 | ↓ -20% |
| Aetna | Commercial | $1,136.16 | ↓ -20% |
| Keystone Autism Services | ACAP | $1,398.78 | ↓ -2% |
| Geisinger | Commercial | $1,549.91 | ↑ +9% |
| Wellspan Population Health | Commercial | $1,656.90 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,656.90 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,763.41 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,011.95 | ↑ +42% |
| Capital Blue Cross | CHIP | $2,577.75 | ↑ +82% |
| Capital Blue Cross | Commercial | $2,577.75 | ↑ +82% |
| Keystone Health Plan | Commercial | $2,577.75 | ↑ +82% |
| Highmark BCBS of PA | Medicaid | $2,895.83 | ↑ +104% |
| Highmark BCBS of PA | Commercial | $3,081.00 | ↑ +117% |
| Cigna | Commercial | $3,397.00 | ↑ +139% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Proctosigmoidoscopy dx 45300 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $817.20 | $24.37 – $1,089.60 |
| UPMC Cole | Coudersport | $780.60 | $25.59 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $1,420.20 | $32.90 – $2,011.95 |
| UPMC Magee | Pittsburgh | $2,279.40 | $26.81 – $938.75 |
| UPMC Passavant-McCandless | Pittsburgh | $1,189.80 | $26.81 – $956.13 |
| UPMC Presbyterian | Pittsburgh | $1,857.60 | $26.81 – $956.13 |
| UPMC Somerset | Somerset | $1,420.20 | $26.81 – $892.40 |
| UPMC St. Margaret | Pittsburgh | $1,663.20 | $26.81 – $956.13 |