Complx repair enel 1.1-2.5 cm 13151 at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$3,731.40
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.
$6,219.00
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.
$194.70 with UPMC Health Plan vs $5,286.15 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 | $194.70 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $194.70 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $262.49 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $276.31 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $301.64 | ↓ -92% |
| UPMC Health Plan | Managed Medicare | $540.93 | ↓ -86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $598.65 | ↓ -84% |
| Aetna of PA | Medicare | $612.77 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $630.28 | ↓ -83% |
| AmeriHealth Caritas | Medicare | $630.28 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $630.28 | ↓ -83% |
| Aetna | Medicare | $641.95 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $682.69 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $844.93 | ↓ -77% |
| UPMC Health Plan | Commercial | $945.85 | ↓ -75% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,768.44 | ↓ -53% |
| Aetna | Neighborhood Network | $2,157.99 | ↓ -42% |
| Aetna | Home Depot Employer Group | $2,344.56 | ↓ -37% |
| Aetna | EBR FI | $2,363.22 | ↓ -37% |
| Highmark BCBS of PA | Managed Care | $2,368.38 | ↓ -37% |
| Aetna | NBR ASO/FI | $2,394.32 | ↓ -36% |
| Cigna | New Business ASO | $2,394.32 | ↓ -36% |
| Aetna | EBR ASO | $2,487.60 | ↓ -33% |
| Cigna | Commercial | $2,487.60 | ↓ -33% |
| UPMC Health Plan | CHIP | $2,636.26 | ↓ -29% |
| InterGroup | PPO | $3,109.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,185.44 | ↓ -15% |
| Cigna Behavioral Health | Commercial | $3,731.40 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,266.17 | ↑ +14% |
| Coventry/First Health | Commercial | $4,353.30 | ↑ +17% |
| Private Health Care Systems | PPO | $4,975.20 | ↑ +33% |
| SelectCare | Commercial | $4,975.20 | ↑ +33% |
| Humana | Commercial | $5,286.15 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Complx repair enel 1.1-2.5 cm 13151 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,637.80 | $177.00 – $4,850.40 |
| UPMC Bedford | Everett | $5,765.40 | $185.85 – $8,648.10 |
| UPMC Carlisle | Carlisle | $1,332.60 | $224.79 – $1,887.85 |
| UPMC Cole | Coudersport | $1,941.60 | $185.85 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $1,332.60 | $224.79 – $2,636.26 |
| UPMC East | Monroeville | $4,030.80 | $194.70 – $5,374.40 |
| UPMC Hamot | Erie | $3,556.80 | $194.70 – $848.80 |
| UPMC Northwest | Seneca | $4,909.80 | $194.70 – $662.27 |