Stent bili dbl pgtl 10fx5cm at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$361.20
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.
$602.00
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.
$66.50 with Prime Net vs $861.28 with UPMC Health Plan — 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 |
|---|---|---|---|
| Prime Net | Managed Medicare | $66.50 | ↓ -82% |
| Keystone Health Plan | Medicare Advantage | $80.60 | ↓ -78% |
| Capital Blue Cross | Medicare Advantage | $80.60 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $132.99 | ↓ -63% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $134.32 | ↓ -63% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $153.14 | ↓ -58% |
| Prime Net | ACO/Legacy Commercial | $165.23 | ↓ -54% |
| Aetna | ACO | $166.44 | ↓ -54% |
| Prime Net | GateKeeper/NonGateKeeper | $192.23 | ↓ -47% |
| Aetna | Commercial | $193.44 | ↓ -46% |
| Aetna | Medicare | $193.55 | ↓ -46% |
| Highmark BCBS of PA | Medicare | $199.49 | ↓ -45% |
| Capital Blue Cross | Commercial | $243.98 | ↓ -32% |
| Capital Blue Cross | CHIP | $243.98 | ↓ -32% |
| United Healthcare | Commercial | $248.25 | ↓ -31% |
| Keystone Health Plan | Commercial | $256.19 | ↓ -29% |
| Geisinger | Commercial | $263.88 | ↓ -27% |
| Wellspan Population Health | Commercial | $282.10 | ↓ -22% |
| UPMC Health Plan | Commercial | $282.10 | ↓ -22% |
| Prime Net | FH-Medical Rental | $300.24 | ↓ -17% |
| Cigna | Commercial | $314.34 | ↓ -13% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $342.55 | ↓ -5% |
| UPMC Health Plan | CHIP | $861.28 | ↑ +138% |
| Highmark Wholecare (prev Gateway) | Medicaid | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Stent bili dbl pgtl 10fx5cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $704.40 | $22.23 – $861.28 |
| UPMC Bedford | Everett | $808.20 | $47.69 – $861.28 |
| UPMC Community Osteopathic | Harrisburg | $361.20 | $80.60 – $861.28 |
| UPMC East | Monroeville | $564.00 | $27.55 – $861.28 |
| UPMC Northwest | Seneca | $712.20 | $1,042.23 – $1,042.23 |
| UPMC Horizon-Greenville | Greenville | $379.80 | $861.28 – $861.28 |
| UPMC Jameson | New Castle | $817.20 | $193.55 – $861.28 |
| UPMC Magee | Pittsburgh | $1,768.80 | $212.91 – $861.28 |