Claviculectomy partial at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
not published by hospital
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.
?
What you pay up front if you don't use insurance.
not published by hospital
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.
?
The hospital's undiscounted list price — almost no one pays this.
$302.50 with United Healthcare Community Plan for Families vs $6,283.24 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 CHIP/PA Medicaid | $302.50 | — |
| UPMC Health Plan | Managed Medicaid | $302.50 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $407.82 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $429.30 | — |
| PA Health & Wellness | PA Medicaid HMO | $468.65 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,244.42 | — |
| UPMC Work Partners | Workers Comp | $1,321.36 | — |
| UPMC Health Plan | Commercial | $1,401.68 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,604.56 | — |
| UPMC Health Plan | Managed Medicare | $2,867.23 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,173.16 | — |
| Aetna of PA | Medicare | $3,248.02 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $3,340.82 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,340.82 | — |
| AmeriHealth Caritas | Medicare | $3,340.82 | — |
| Aetna | Medicare | $3,402.68 | — |
| Highmark BCBS of PA | Managed Care | $3,488.16 | — |
| UPMC Health Plan | CHIP | $3,906.73 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,691.53 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $6,283.24 | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Claviculectomy partial at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,090.80 | $288.75 – $1,677.17 |
| UPMC Kane | Kane | $4,007.40 | $302.50 – $2,492.79 |
| Uniontown Hospital | Uniontown | $4,201.75 | $3,171.41 – $7,389.39 |
| UPMC Carlisle | Carlisle | not published | $349.25 – $4,966.18 |
| UPMC Community Osteopathic | Harrisburg | not published | $371.25 – $7,348.95 |
| UPMC East | Monroeville | not published | $302.50 – $3,402.68 |
| UPMC Hamot | Erie | not published | $302.50 – $4,499.05 |
| UPMC Northwest | Seneca | not published | $302.50 – $3,248.02 |