Repair tongue lac <2.5cm past 1/3 tongue 41251 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$1,050.60
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.
$1,751.00
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.
$40.01 with AmeriHealth Caritas vs $2,577.75 with Capital Blue Cross — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $40.01 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $40.01 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $40.95 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $42.90 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $45.88 | ↓ -96% |
| Aetna | Medicare | $232.26 | ↓ -78% |
| Cigna | Medicare | $233.81 | ↓ -78% |
| Geisinger | Medicare | $233.81 | ↓ -78% |
| United Healthcare | Medicare | $238.27 | ↓ -77% |
| Prime Net | Managed Medicare | $288.92 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $350.20 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $350.20 | ↓ -67% |
| Keystone Autism Services | ACAP | $356.29 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $428.26 | ↓ -59% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -43% |
| United Healthcare Community Plan for Families | PA Medicaid | $645.83 | ↓ -39% |
| Prime Net | ACO/Legacy Commercial | $717.91 | ↓ -32% |
| Aetna | ACO | $723.16 | ↓ -31% |
| Highmark BCBS of PA | Medicaid | $737.61 | ↓ -30% |
| Highmark BCBS of PA | Commercial | $784.77 | ↓ -25% |
| Prime Net | GateKeeper/NonGateKeeper | $835.23 | ↓ -20% |
| Aetna | Commercial | $840.48 | ↓ -20% |
| Geisinger | Commercial | $1,146.55 | ↑ +9% |
| Wellspan Population Health | Commercial | $1,225.70 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,225.70 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,304.49 | ↑ +24% |
| Cigna | Commercial | $1,365.78 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,488.35 | ↑ +42% |
| UPMC Health Plan | CHIP | $2,297.57 | ↑ +119% |
| Capital Blue Cross | Commercial | $2,577.75 | ↑ +145% |
| Keystone Health Plan | Commercial | $2,577.75 | ↑ +145% |
| Capital Blue Cross | CHIP | $2,577.75 | ↑ +145% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Repair tongue lac <2.5cm past 1/3 tongue 41251 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,050.60 | $40.01 – $1,488.35 |
| UPMC Community Osteopathic | Harrisburg | $1,050.60 | $40.01 – $2,297.57 |
| UPMC Hanover | Hanover | $1,050.60 | $40.01 – $645.83 |
| UPMC Lititz | Lititz | $1,050.60 | $40.01 – $645.83 |
| UPMC Somerset | Somerset | $1,050.60 | $34.65 – $566.95 |
| Uniontown Hospital | Uniontown | $309.00 | $34.65 – $476.82 |
| WellSpan Good Samaritan Hospital | Lebanon | $390.40 | $39.38 – $2,402.40 |
| WellSpan Newberry Hospital | Etters | not published | not published |