Vein x-ray spleen/liver at UPMC Memorial
1701 Innovation Drive, York, PA · UPMC · · NPI 1063945707
$3,476.40
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.
$5,794.00
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.
$51.09 with United Healthcare Community Plan for Families vs $10,636.53 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 | $51.09 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $82.55 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $82.55 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $84.50 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $88.53 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $94.68 | ↓ -97% |
| Highmark BCBS of PA | Medicare | $492.84 | ↓ -86% |
| Prime Net | Managed Medicare | $956.01 | ↓ -73% |
| Capital Blue Cross | Medicare Advantage | $1,158.80 | ↓ -67% |
| Keystone Health Plan | Medicare Advantage | $1,158.80 | ↓ -67% |
| Premier Comp Solutions | Worker's Comp | $1,271.52 | ↓ -63% |
| UPMC Work Partners | Workers Comp | $1,271.52 | ↓ -63% |
| UPMC Health Plan | CHIP | $1,920.30 | ↓ -45% |
| Prime Net | ACO/Legacy Commercial | $2,375.54 | ↓ -32% |
| Aetna | ACO | $2,392.92 | ↓ -31% |
| Prime Net | GateKeeper/NonGateKeeper | $2,763.74 | ↓ -20% |
| Aetna | Commercial | $2,781.12 | ↓ -20% |
| Capital Blue Cross | CHIP | $3,032.25 | ↓ -13% |
| Keystone Health Plan | Commercial | $3,032.25 | ↓ -13% |
| Capital Blue Cross | Commercial | $3,032.25 | ↓ -13% |
| Aetna | Medicare | $3,147.92 | ↓ -9% |
| Cigna | Medicare | $3,169.05 | ↓ -9% |
| Geisinger | Medicare | $3,169.05 | ↓ -9% |
| United Healthcare | Medicare | $3,229.41 | ↓ -7% |
| Geisinger | Commercial | $3,793.91 | ↑ +9% |
| Wellspan Population Health | Commercial | $4,055.80 | ↑ +17% |
| UPMC Health Plan | Commercial | $4,055.80 | ↑ +17% |
| United Healthcare | Commercial | $4,264.38 | ↑ +23% |
| Prime Net | FH-Medical Rental | $4,316.53 | ↑ +24% |
| Keystone Autism Services | ACAP | $4,829.02 | ↑ +39% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $4,924.90 | ↑ +42% |
| Cigna | Commercial | $8,572.42 | ↑ +147% |
| Highmark BCBS of PA | Medicaid | $9,997.29 | ↑ +188% |
| Highmark BCBS of PA | Commercial | $10,636.53 | ↑ +206% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Vein x-ray spleen/liver at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $3,476.40 | $51.09 – $4,924.90 |
| UPMC Community Osteopathic | Harrisburg | $3,476.40 | $51.09 – $4,924.90 |
| UPMC Hanover | Hanover | $3,476.40 | $51.09 – $4,810.90 |
| UPMC Lititz | Lititz | $3,476.40 | $51.09 – $4,836.88 |
| UPMC Mercy | Pittsburgh | $1,590.60 | $71.50 – $3,300.84 |
| UPMC Presbyterian | Pittsburgh | $3,324.60 | $46.80 – $3,300.84 |
| UPMC Somerset | Somerset | $3,476.40 | $44.85 – $3,000.76 |