Colonoscopy w/fb removal at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$2,985.60
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.
$4,976.00
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.
$260.75 with UPMC Health Plan vs $4,229.60 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 | $260.75 | ↓ -91% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $260.75 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $351.55 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $370.06 | ↓ -88% |
| PA Health & Wellness | PA Medicaid HMO | $403.98 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -75% |
| UPMC Health Plan | Commercial | $824.94 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $1,041.94 | ↓ -65% |
| UPMC Work Partners | Workers Comp | $1,048.46 | ↓ -65% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,153.11 | ↓ -61% |
| Aetna of PA | Medicare | $1,180.32 | ↓ -60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,214.04 | ↓ -59% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,214.04 | ↓ -59% |
| AmeriHealth Caritas | Medicare | $1,214.04 | ↓ -59% |
| Aetna | Medicare | $1,236.52 | ↓ -59% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,542.02 | ↓ -48% |
| Aetna | Neighborhood Network | $1,726.67 | ↓ -42% |
| Aetna | Home Depot Employer Group | $1,875.95 | ↓ -37% |
| Aetna | EBR FI | $1,890.88 | ↓ -37% |
| Cigna | New Business ASO | $1,915.76 | ↓ -36% |
| Aetna | NBR ASO/FI | $1,915.76 | ↓ -36% |
| Aetna | EBR ASO | $1,990.40 | ↓ -33% |
| Cigna | Commercial | $1,990.40 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $2,065.14 | ↓ -31% |
| UPMC Health Plan | CHIP | $2,299.25 | ↓ -23% |
| InterGroup | PPO | $2,488.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,777.59 | ↓ -7% |
| Cigna Behavioral Health | Commercial | $2,985.60 | ↑ +0% |
| Coventry/First Health | Commercial | $3,483.20 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,719.96 | ↑ +25% |
| Private Health Care Systems | PPO | $3,980.80 | ↑ +33% |
| SelectCare | Commercial | $3,980.80 | ↑ +33% |
| Humana | Commercial | $4,229.60 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy w/fb removal at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,764.60 | $237.05 – $2,352.80 |
| UPMC Bedford | Everett | $5,239.80 | $248.90 – $7,859.70 |
| UPMC East | Monroeville | $3,211.80 | $260.75 – $4,282.40 |
| UPMC Hamot | Erie | $3,045.00 | $260.75 – $1,634.95 |
| UPMC Horizon-Greenville | Greenville | $3,080.40 | $260.75 – $1,419.79 |
| UPMC Magee | Pittsburgh | $5,238.60 | $260.75 – $1,214.04 |
| UPMC Mercy | Pittsburgh | $3,141.00 | $260.75 – $1,236.52 |
| UPMC Passavant-McCandless | Pittsburgh | $2,346.60 | $260.75 – $1,236.52 |