Absorpt drg >16<=48 in w/bdr at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$1.80
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.
$3.00
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.
$0.25 with Aetna vs $34.95 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | Medicare | $0.25 | ↓ -86% |
| Aetna | Neighborhood Network | $0.35 | ↓ -81% |
| Aetna | EBR FI | $0.38 | ↓ -79% |
| Aetna | Home Depot Employer Group | $0.38 | ↓ -79% |
| Cigna | New Business ASO | $0.39 | ↓ -78% |
| Aetna | NBR ASO/FI | $0.39 | ↓ -78% |
| Aetna | EBR ASO | $0.40 | ↓ -78% |
| Cigna | Commercial | $0.40 | ↓ -78% |
| InterGroup | PPO | $0.50 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicare | $0.50 | ↓ -72% |
| PA Health & Wellness | PA Medicaid HMO | $0.55 | ↓ -69% |
| Cigna Behavioral Health | Commercial | $0.60 | ↓ -67% |
| Coventry/First Health | Commercial | $0.70 | ↓ -61% |
| Private Health Care Systems | PPO | $0.80 | ↓ -56% |
| SelectCare | Commercial | $0.80 | ↓ -56% |
| Humana | Commercial | $0.85 | ↓ -53% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $5.42 | ↑ +201% |
| UPMC Work Partners | Workers Comp | $7.02 | ↑ +290% |
| UPMC Health Plan | CHIP | $16.97 | ↑ +843% |
| Highmark BCBS of PA | Managed Care - Social Mission | $20.28 | ↑ +1027% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $20.45 | ↑ +1036% |
| Highmark BCBS of PA | Managed Care | $27.16 | ↑ +1409% |
| Highmark BCBS of PA | Commercial - Indemnity | $27.38 | ↑ +1421% |
| UPMC Health Plan | Commercial | $34.95 | ↑ +1842% |
Visitor-reported prices
Comments
Absorpt drg >16<=48 in w/bdr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1.80 | $0.50 – $16.97 |
| UPMC Bedford | Everett | $0.60 | $0.25 – $16.97 |
| UPMC East | Monroeville | $1.80 | $0.25 – $16.97 |
| UPMC Hamot | Erie | $1.80 | $5.37 – $7.02 |
| UPMC Northwest | Seneca | $0.60 | $7.02 – $20.53 |
| UPMC Magee | Pittsburgh | $1.80 | $2.86 – $16.97 |
| UPMC Passavant-McCandless | Pittsburgh | $1.80 | $5.42 – $24.62 |
| UPMC Presbyterian | Pittsburgh | $2.40 | $3.28 – $27.43 |