Revision tips at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$7,508.40
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.
?
What you pay up front if you don't use insurance.
$12,514.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$639.25 with Highmark BCBS of PA vs $22,309.35 with Capital Blue Cross — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $639.25 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $832.42 | ↓ -89% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -86% |
| Prime Net | Managed Medicare | $2,064.81 | ↓ -73% |
| Keystone Health Plan | Medicare Advantage | $2,502.80 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,502.80 | ↓ -67% |
| Prime Net | ACO/Legacy Commercial | $5,130.74 | ↓ -32% |
| Aetna | ACO | $5,168.28 | ↓ -31% |
| Aetna | Medicare | $5,702.28 | ↓ -24% |
| Cigna | Medicare | $5,740.55 | ↓ -24% |
| Geisinger | Medicare | $5,740.55 | ↓ -24% |
| United Healthcare | Medicare | $5,849.89 | ↓ -22% |
| Prime Net | GateKeeper/NonGateKeeper | $5,969.18 | ↓ -20% |
| Aetna | Commercial | $6,006.72 | ↓ -20% |
| Geisinger | Medicaid/CHIP | $6,882.70 | ↓ -8% |
| UPMC Health Plan | CHIP | $8,144.64 | ↑ +8% |
| Geisinger | Commercial | $8,194.17 | ↑ +9% |
| Keystone Autism Services | ACAP | $8,747.50 | ↑ +17% |
| Wellspan Population Health | Commercial | $8,759.80 | ↑ +17% |
| UPMC Health Plan | Commercial | $8,759.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $9,322.93 | ↑ +24% |
| Cigna | Commercial | $9,539.00 | ↑ +27% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $10,636.90 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $18,109.52 | ↑ +141% |
| Highmark BCBS of PA | Commercial | $19,267.47 | ↑ +157% |
| Capital Blue Cross | Commercial | $22,309.35 | ↑ +197% |
| Keystone Health Plan | Commercial | $22,309.35 | ↑ +197% |
| Capital Blue Cross | CHIP | $22,309.35 | ↑ +197% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Revision tips at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $7,508.40 | $832.42 – $10,636.90 |
| UPMC Community Osteopathic | Harrisburg | $7,508.40 | $832.42 – $10,636.90 |
| UPMC Hamot | Erie | $11,371.20 | $784.32 – $7,905.86 |
| UPMC Hanover | Hanover | $7,508.40 | $832.42 – $8,714.66 |
| UPMC Lititz | Lititz | $7,508.40 | $832.42 – $8,761.73 |
| UPMC Mercy | Pittsburgh | $7,783.80 | $784.32 – $5,979.29 |
| UPMC Passavant-McCandless | Pittsburgh | $5,080.80 | $791.79 – $5,979.29 |
| UPMC Presbyterian | Pittsburgh | $10,992.60 | $791.79 – $5,979.29 |