healthcosts.net
Colonoscopy (diagnostic) at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$1,500.00
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.
$2,500.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$198.55 with UPMC Health Plan vs $3,719.96 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $198.55 | ↓ -87% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $198.55 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $267.68 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $281.78 | ↓ -81% |
| PA Health & Wellness | PA Medicaid HMO | $307.61 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -51% |
| UPMC Work Partners | Workers Comp | $780.97 | ↓ -48% |
| UPMC Health Plan | Managed Medicare | $805.67 | ↓ -46% |
| UPMC Health Plan | Commercial | $830.80 | ↓ -45% |
| Aetna | Neighborhood Network | $867.50 | ↓ -42% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $891.64 | ↓ -41% |
| Aetna of PA | Medicare | $912.67 | ↓ -39% |
| AmeriHealth Caritas | Medicare | $938.75 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.75 | ↓ -37% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↓ -37% |
| Aetna | Home Depot Employer Group | $942.50 | ↓ -37% |
| Aetna | EBR FI | $950.00 | ↓ -37% |
| Aetna | Medicare | $956.13 | ↓ -36% |
| Aetna | NBR ASO/FI | $962.50 | ↓ -36% |
| Cigna | New Business ASO | $962.50 | ↓ -36% |
| Cigna | Commercial | $1,000.00 | ↓ -33% |
| Aetna | EBR ASO | $1,000.00 | ↓ -33% |
| InterGroup | PPO | $1,250.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $1,500.00 | ↑ +0% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,542.02 | ↑ +3% |
| Coventry/First Health | Commercial | $1,750.00 | ↑ +17% |
| Private Health Care Systems | PPO | $2,000.00 | ↑ +33% |
| SelectCare | Commercial | $2,000.00 | ↑ +33% |
| Highmark BCBS of PA | Managed Care | $2,065.14 | ↑ +38% |
| Humana | Commercial | $2,125.00 | ↑ +42% |
| UPMC Health Plan | CHIP | $2,315.60 | ↑ +54% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,777.59 | ↑ +85% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,719.96 | ↑ +148% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy (diagnostic) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,685.40 | $198.55 – $2,125.00 |
| UPMC Altoona | Altoona | $1,500.00 | $180.50 – $2,000.00 |
| UPMC Cole | Coudersport | $609.00 | $189.53 – $1,041.88 |
| UPMC East | Monroeville | $1,500.00 | $198.55 – $2,000.00 |
| UPMC Hamot | Erie | $1,500.00 | $198.55 – $1,750.00 |
| UPMC Horizon-Greenville | Greenville | $1,500.00 | $198.55 – $2,125.00 |
| UPMC Jameson | New Castle | $1,500.00 | $198.55 – $2,200.00 |
| UPMC Bedford | Everett | $1,500.00 | $189.53 – $2,250.00 |