Treatment of ankle fracture at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
not published by hospital
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.
not published by hospital
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.
$631.83 with Highmark Wholecare (prev Gateway) vs $24,141.19 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $631.83 | — |
| UPMC Health Plan | Managed Medicaid | $646.75 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $671.62 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $677.60 | — |
| Highmark BCBS of PA | Medicare | $682.16 | — |
| Geisinger | Medicaid/CHIP | $724.66 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| UPMC Work Partners | Workers Comp | $2,451.11 | — |
| UPMC Health Plan | CHIP | $2,637.94 | — |
| Cigna | Commercial | $6,413.00 | — |
| Aetna | Medicare | $7,144.68 | — |
| Geisinger | Medicare | $7,192.63 | — |
| Cigna | Medicare | $7,192.63 | — |
| United Healthcare | Medicare | $7,329.63 | — |
| Keystone Autism Services | ACAP | $10,960.19 | — |
| Keystone Health Plan | Commercial | $15,450.75 | — |
| Capital Blue Cross | Commercial | $15,450.75 | — |
| Capital Blue Cross | CHIP | $15,450.75 | — |
| Highmark BCBS of PA | Medicaid | $22,690.34 | — |
| Highmark BCBS of PA | Commercial | $24,141.19 | — |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of ankle fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,960.80 | $522.38 – $2,614.40 |
| UPMC Williamsport | Williamsport | $5,152.80 | $547.25 – $7,287.44 |
| Uniontown Hospital | Uniontown | $11,138.50 | $7,033.14 – $16,387.22 |
| UPMC Community Osteopathic | Harrisburg | not published | $671.62 – $15,488.55 |
| UPMC East | Monroeville | not published | $547.25 – $7,491.76 |
| UPMC Northwest | Seneca | not published | $547.25 – $7,151.22 |
| UPMC Lititz | Lititz | not published | $631.83 – $10,978.03 |
| UPMC Mercy | Pittsburgh | not published | $547.25 – $7,491.76 |