Stent/tib/peroneal/unilat/initial 37230 at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$24,161.40
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.
$40,269.00
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.
$1,016.56 with United Healthcare Community Plan for Families vs $60,682.14 with Highmark BCBS of PA — 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 | $1,016.56 | ↓ -96% |
| Prime Net | Managed Medicare | $6,644.39 | ↓ -72% |
| Capital Blue Cross | Medicare Advantage | $8,053.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $8,053.80 | ↓ -67% |
| Keystone Health Plan | Commercial | $9,437.40 | ↓ -61% |
| Cigna | Commercial | $9,539.00 | ↓ -61% |
| Highmark BCBS of PA | Medicare | $12,210.95 | ↓ -49% |
| UPMC Work Partners | Workers Comp | $12,871.17 | ↓ -47% |
| Prime Net | ACO/Legacy Commercial | $16,510.29 | ↓ -32% |
| Aetna | ACO | $16,631.10 | ↓ -31% |
| Aetna | Medicare | $17,959.10 | ↓ -26% |
| Cigna | Medicare | $18,079.63 | ↓ -25% |
| Geisinger | Medicare | $18,079.63 | ↓ -25% |
| United Healthcare | Medicare | $18,424.01 | ↓ -24% |
| Prime Net | GateKeeper/NonGateKeeper | $19,208.31 | ↓ -21% |
| Aetna | Commercial | $19,329.12 | ↓ -20% |
| Geisinger | Medicaid/CHIP | $22,147.95 | ↓ -8% |
| Capital Blue Cross | Commercial | $22,309.35 | ↓ -8% |
| Capital Blue Cross | CHIP | $22,309.35 | ↓ -8% |
| Geisinger | Commercial | $26,368.14 | ↑ +9% |
| Keystone Autism Services | ACAP | $27,549.92 | ↑ +14% |
| UPMC Health Plan | Commercial | $28,188.30 | ↑ +17% |
| UPMC Health Plan | CHIP | $28,188.30 | ↑ +17% |
| Wellspan Population Health | Commercial | $28,188.30 | ↑ +17% |
| Prime Net | FH-Medical Rental | $30,000.40 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $34,228.65 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $57,035.22 | ↑ +136% |
| Highmark BCBS of PA | Commercial | $60,682.14 | ↑ +151% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Stent/tib/peroneal/unilat/initial 37230 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $34,008.60 | $12,299.12 – $45,344.80 |
| UPMC Carlisle | Carlisle | $24,161.40 | $1,016.56 – $34,228.65 |
| UPMC Community Osteopathic | Harrisburg | $24,161.40 | $1,016.56 – $34,228.65 |
| UPMC East | Monroeville | $35,436.00 | $12,299.12 – $47,248.00 |
| UPMC Hamot | Erie | $31,604.40 | $644.90 – $24,899.21 |
| UPMC Hanover | Hanover | $24,161.40 | $1,016.56 – $27,446.48 |
| UPMC Lititz | Lititz | $24,161.40 | $1,016.56 – $27,594.74 |
| UPMC Passavant-McCandless | Pittsburgh | $34,695.00 | $12,299.12 – $18,831.54 |