healthcosts.net
Shoulder X-ray at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$188.40
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.
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What you pay up front if you don't use insurance.
$314.00
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.
$21.61 with United Healthcare Community Plan for Families vs $419.44 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $21.61 | ↓ -89% |
| Highmark BCBS of PA | Medicare | $28.91 | ↓ -85% |
| Aetna | Medicare | $30.10 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.65 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $31.65 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $32.40 | ↓ -83% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $33.94 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $36.30 | ↓ -81% |
| Prime Net | Managed Medicare | $51.81 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $62.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $62.80 | ↓ -67% |
| Premier Comp Solutions | Worker's Comp | $76.84 | ↓ -59% |
| UPMC Work Partners | Workers Comp | $76.84 | ↓ -59% |
| UPMC Health Plan | CHIP | $102.98 | ↓ -45% |
| Capital Blue Cross | CHIP | $123.63 | ↓ -34% |
| Capital Blue Cross | Commercial | $123.63 | ↓ -34% |
| Keystone Health Plan | Commercial | $123.63 | ↓ -34% |
| Prime Net | ACO/Legacy Commercial | $128.74 | ↓ -32% |
| Aetna | ACO | $129.68 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $149.78 | ↓ -20% |
| Aetna | Commercial | $150.72 | ↓ -20% |
| Geisinger | Commercial | $205.61 | ↑ +9% |
| UPMC Health Plan | Commercial | $219.80 | ↑ +17% |
| Wellspan Population Health | Commercial | $219.80 | ↑ +17% |
| United Healthcare | Commercial | $231.10 | ↑ +23% |
| Prime Net | FH-Medical Rental | $233.93 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $266.90 | ↑ +42% |
| Cigna | Commercial | $419.44 | ↑ +123% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $436.20 | $28.33 – $581.60 |
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $28.58 – $594.15 |
| UPMC Hamot | Erie | $341.40 | $21.87 – $398.30 |
| UPMC Carlisle | Carlisle | $188.40 | $21.61 – $419.44 |
| UPMC Altoona | Altoona | $172.80 | $35.47 – $230.40 |
| UPMC Bedford | Everett | $127.80 | $28.72 – $191.70 |
| UPMC Cole | Coudersport | $144.60 | $31.80 – $192.80 |
| UPMC Community Osteopathic | Harrisburg | $188.40 | $21.61 – $266.90 |