Benign lesion paring 4+ at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$436.20
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.
$727.00
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.
$42.83 with UPMC Health Plan vs $617.95 with Humana — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $42.83 | ↓ -90% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $42.83 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $57.75 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $60.79 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $62.29 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $66.36 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $110.11 | ↓ -75% |
| UPMC Health Plan | Commercial | $150.87 | ↓ -65% |
| UPMC Health Plan | Managed Medicare | $175.59 | ↓ -60% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $194.33 | ↓ -55% |
| Aetna of PA | Medicare | $198.91 | ↓ -54% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $204.60 | ↓ -53% |
| Highmark Wholecare (prev Gateway) | Medicare | $204.60 | ↓ -53% |
| AmeriHealth Caritas | Medicare | $204.60 | ↓ -53% |
| Aetna | Medicare | $208.38 | ↓ -52% |
| Highmark BCBS of PA | Managed Care - Social Mission | $230.47 | ↓ -47% |
| Aetna | Neighborhood Network | $252.27 | ↓ -42% |
| Aetna | Home Depot Employer Group | $274.08 | ↓ -37% |
| Aetna | EBR FI | $276.26 | ↓ -37% |
| Cigna | New Business ASO | $279.89 | ↓ -36% |
| Aetna | NBR ASO/FI | $279.89 | ↓ -36% |
| Cigna | Commercial | $290.80 | ↓ -33% |
| Aetna | EBR ASO | $290.80 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $308.65 | ↓ -29% |
| InterGroup | PPO | $363.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $415.13 | ↓ -5% |
| UPMC Health Plan | CHIP | $420.50 | ↓ -4% |
| Cigna Behavioral Health | Commercial | $436.20 | ↑ +0% |
| Coventry/First Health | Commercial | $508.90 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $555.98 | ↑ +27% |
| SelectCare | Commercial | $581.60 | ↑ +33% |
| Private Health Care Systems | PPO | $581.60 | ↑ +33% |
| Humana | Commercial | $617.95 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Benign lesion paring 4+ at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $671.40 | $38.94 – $895.20 |
| UPMC Carlisle | Carlisle | $435.60 | $49.45 – $1,016.56 |
| UPMC Cole | Coudersport | $210.60 | $13.58 – $2,094.25 |
| UPMC Community Osteopathic | Harrisburg | $435.60 | $49.45 – $1,016.56 |
| UPMC Hanover | Hanover | $435.60 | $49.45 – $1,016.56 |
| UPMC Jameson | New Castle | $479.40 | $42.83 – $892.40 |
| UPMC Kane | Kane | $141.00 | $42.83 – $373.29 |
| UPMC Lititz | Lititz | $435.60 | $49.45 – $1,016.56 |