Surgical pathology level 6 gross & microscopic examination at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$1,472.40
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.
$2,454.00
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.
$22.93 with United Healthcare Community Plan for Families vs $2,760.61 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 | $22.93 | ↓ -98% |
| Highmark BCBS of PA | Medicare | $54.43 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $67.60 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $85.85 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $87.88 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $92.07 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $98.47 | ↓ -93% |
| UPMC Health Plan | CHIP | $197.01 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $386.97 | ↓ -74% |
| Prime Net | Managed Medicare | $404.91 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $490.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $490.80 | ↓ -67% |
| Cigna | Commercial | $715.00 | ↓ -51% |
| Capital Blue Cross | Commercial | $809.98 | ↓ -45% |
| Capital Blue Cross | CHIP | $809.98 | ↓ -45% |
| Keystone Health Plan | Commercial | $809.98 | ↓ -45% |
| Aetna | Medicare | $817.01 | ↓ -45% |
| Cigna | Medicare | $822.50 | ↓ -44% |
| Geisinger | Medicare | $822.50 | ↓ -44% |
| United Healthcare | Medicare | $838.16 | ↓ -43% |
| Prime Net | ACO/Legacy Commercial | $1,006.14 | ↓ -32% |
| Aetna | ACO | $1,013.50 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $1,170.56 | ↓ -20% |
| Aetna | Commercial | $1,177.92 | ↓ -20% |
| Keystone Autism Services | ACAP | $1,253.33 | ↓ -15% |
| Geisinger | Commercial | $1,606.88 | ↑ +9% |
| UPMC Health Plan | Commercial | $1,717.80 | ↑ +17% |
| Wellspan Population Health | Commercial | $1,717.80 | ↑ +17% |
| Prime Net | FH-Medical Rental | $1,828.23 | ↑ +24% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,085.90 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $2,594.70 | ↑ +76% |
| Highmark BCBS of PA | Commercial | $2,760.61 | ↑ +87% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Surgical pathology level 6 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $336.00 | $17.50 – $448.00 |
| UPMC Bedford | Everett | $273.00 | $54.94 – $409.50 |
| UPMC Carlisle | Carlisle | $1,472.40 | $22.93 – $2,085.90 |
| UPMC Cole | Coudersport | $811.20 | $53.00 – $1,081.60 |
| UPMC Community Osteopathic | Harrisburg | $1,472.40 | $22.93 – $2,085.90 |
| UPMC East | Monroeville | $516.00 | $54.19 – $817.76 |
| UPMC Hamot | Erie | $320.40 | $66.79 – $970.76 |
| UPMC Northwest | Seneca | $691.20 | $54.70 – $817.76 |