Tx open iphlngl jt disl internal fixation sngl at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$6,223.80
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.
$10,373.00
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.
$150.50 with Highmark Wholecare (prev Gateway) vs $10,964.70 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 | $150.50 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $150.50 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $154.05 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $161.40 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $172.61 | ↓ -97% |
| Highmark BCBS of PA | Medicare | $594.82 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $720.76 | ↓ -88% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -84% |
| Prime Net | Managed Medicare | $1,711.55 | ↓ -72% |
| Keystone Health Plan | Medicare Advantage | $2,074.60 | ↓ -67% |
| Capital Blue Cross | Medicare Advantage | $2,074.60 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,315.04 | ↓ -63% |
| Aetna | Medicare | $3,245.04 | ↓ -48% |
| Geisinger | Medicare | $3,266.82 | ↓ -48% |
| Cigna | Medicare | $3,266.82 | ↓ -48% |
| United Healthcare | Medicare | $3,329.05 | ↓ -47% |
| Prime Net | ACO/Legacy Commercial | $4,252.93 | ↓ -32% |
| Aetna | ACO | $4,284.05 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $4,947.92 | ↓ -21% |
| Keystone Autism Services | ACAP | $4,978.02 | ↓ -20% |
| Aetna | Commercial | $4,979.04 | ↓ -20% |
| Geisinger | Commercial | $6,792.24 | ↑ +9% |
| Capital Blue Cross | Commercial | $7,073.85 | ↑ +14% |
| Capital Blue Cross | CHIP | $7,073.85 | ↑ +14% |
| Keystone Health Plan | Commercial | $7,105.35 | ↑ +14% |
| Wellspan Population Health | Commercial | $7,261.10 | ↑ +17% |
| UPMC Health Plan | Commercial | $7,261.10 | ↑ +17% |
| Prime Net | FH-Medical Rental | $7,727.89 | ↑ +24% |
| Cigna | Commercial | $8,090.94 | ↑ +30% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $8,817.05 | ↑ +42% |
| Highmark BCBS of PA | Medicaid | $10,305.74 | ↑ +66% |
| Highmark BCBS of PA | Commercial | $10,964.70 | ↑ +76% |
| United Healthcare | Commercial | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Tx open iphlngl jt disl internal fixation sngl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $6,223.80 | $150.50 – $8,817.05 |
| UPMC Community Osteopathic | Harrisburg | $6,223.80 | $150.50 – $8,817.05 |
| UPMC Hamot | Erie | $4,234.20 | $130.35 – $4,499.05 |
| UPMC Northwest | Seneca | $4,281.00 | $130.35 – $3,248.02 |
| UPMC Hanover | Hanover | $6,223.80 | $150.50 – $4,959.33 |
| UPMC Lititz | Lititz | $6,223.80 | $150.50 – $4,986.11 |
| UPMC Mercy | Pittsburgh | $3,601.80 | $130.35 – $3,402.68 |
| UPMC Presbyterian | Pittsburgh | $5,289.00 | $130.35 – $3,402.68 |