Tx closed tib shaft fx without manip at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$1,408.20
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.
$2,347.00
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.
$180.97 with Highmark Wholecare (prev Gateway) vs $1,994.95 with Multiplan — 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 | $180.97 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $180.97 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $185.25 | ↓ -87% |
| United Healthcare Community Plan for Families | PA Medicaid | $186.68 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $194.09 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $207.57 | ↓ -85% |
| Aetna | Medicare | $239.91 | ↓ -83% |
| Cigna | Medicare | $241.52 | ↓ -83% |
| Geisinger | Medicare | $241.52 | ↓ -83% |
| United Healthcare | Medicare | $246.12 | ↓ -83% |
| Keystone Autism Services | ACAP | $368.03 | ↓ -74% |
| Prime Net | Managed Medicare | $387.25 | ↓ -73% |
| Highmark BCBS of PA | Medicare | $444.23 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $469.40 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $469.40 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $699.63 | ↓ -50% |
| Highmark BCBS of PA | Medicaid | $761.92 | ↓ -46% |
| Highmark BCBS of PA | Commercial | $810.64 | ↓ -42% |
| Prime Net | ACO/Legacy Commercial | $962.27 | ↓ -32% |
| Aetna | ACO | $969.31 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $1,119.52 | ↓ -20% |
| Aetna | Commercial | $1,126.56 | ↓ -20% |
| Keystone Health Plan | Commercial | $1,310.40 | ↓ -7% |
| Capital Blue Cross | Commercial | $1,310.40 | ↓ -7% |
| Capital Blue Cross | CHIP | $1,310.40 | ↓ -7% |
| Geisinger | Commercial | $1,536.82 | ↑ +9% |
| Wellspan Population Health | Commercial | $1,642.90 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,642.90 | ↑ +17% |
| UPMC Health Plan | CHIP | $1,714.10 | ↑ +22% |
| Prime Net | FH-Medical Rental | $1,748.52 | ↑ +24% |
| Cigna | Commercial | $1,830.66 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,994.95 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Tx closed tib shaft fx without manip at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $1,689.60 | $82.51 – $2,534.40 |
| UPMC Carlisle | Carlisle | $1,408.20 | $180.97 – $1,994.95 |
| UPMC Cole | Coudersport | $1,266.00 | $79.28 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $1,408.20 | $180.97 – $1,994.95 |
| UPMC Hanover | Hanover | $1,408.20 | $180.97 – $699.63 |
| UPMC Kane | Kane | $345.60 | $156.75 – $1,489.19 |
| UPMC Lititz | Lititz | $1,408.20 | $180.97 – $743.00 |
| UPMC Muncy | Muncy | $718.20 | $156.75 – $880.43 |