Egd/remov tum/polyp/hot bx forcep 43250 at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$6,238.80
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.
$10,398.00
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.
$736.75 with Highmark BCBS of PA vs $8,838.30 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -88% |
| UPMC Health Plan | Commercial | $830.64 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $1,134.32 | ↓ -82% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,542.02 | ↓ -75% |
| UPMC Health Plan | Managed Medicare | $1,676.34 | ↓ -73% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,855.21 | ↓ -70% |
| Aetna of PA | Medicare | $1,898.98 | ↓ -70% |
| AmeriHealth Caritas | Medicare | $1,953.23 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,953.23 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,953.23 | ↓ -69% |
| Aetna | Medicare | $1,989.40 | ↓ -68% |
| Highmark BCBS of PA | Managed Care | $2,065.14 | ↓ -67% |
| UPMC Health Plan | CHIP | $2,315.15 | ↓ -63% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,777.59 | ↓ -55% |
| Aetna | Neighborhood Network | $3,608.11 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,719.96 | ↓ -40% |
| Aetna | Home Depot Employer Group | $3,920.05 | ↓ -37% |
| Aetna | EBR FI | $3,951.24 | ↓ -37% |
| Aetna | NBR ASO/FI | $4,003.23 | ↓ -36% |
| Cigna | New Business ASO | $4,003.23 | ↓ -36% |
| Cigna | Commercial | $4,159.20 | ↓ -33% |
| Aetna | EBR ASO | $4,159.20 | ↓ -33% |
| InterGroup | PPO | $5,199.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $5,718.90 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $6,238.80 | ↑ +0% |
| Coventry/First Health | Commercial | $7,278.60 | ↑ +17% |
| Private Health Care Systems | PPO | $8,318.40 | ↑ +33% |
| SelectCare | Commercial | $8,318.40 | ↑ +33% |
| Humana | Commercial | $8,838.30 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Egd/remov tum/polyp/hot bx forcep 43250 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,675.80 | $729.80 – $2,234.40 |
| UPMC Bedford | Everett | $4,410.60 | $652.52 – $6,615.90 |
| UPMC Cole | Coudersport | $343.80 | $158.84 – $1,072.14 |
| UPMC Northwest | Seneca | $4,283.40 | $1,093.66 – $1,953.23 |
| UPMC Horizon-Greenville | Greenville | $2,476.20 | $1,101.28 – $1,953.23 |
| UPMC Jameson | New Castle | $2,476.20 | $742.68 – $2,441.54 |
| UPMC Magee | Pittsburgh | $2,680.20 | $736.75 – $1,989.40 |
| UPMC Passavant-McCandless | Pittsburgh | $3,867.60 | $736.75 – $1,989.40 |