Ercp remove forgn body duct 43275 at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$6,680.40
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.
$11,134.00
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.
$300.00 with Highmark BCBS of PA vs $9,463.90 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 | $300.00 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $565.94 | ↓ -92% |
| Highmark BCBS of PA | Managed Care - Social Mission | $783.60 | ↓ -88% |
| Highmark BCBS of PA | Managed Care | $1,049.48 | ↓ -84% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,131.00 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,514.72 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $1,676.34 | ↓ -75% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,855.21 | ↓ -72% |
| Aetna of PA | Medicare | $1,898.98 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,953.23 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,953.23 | ↓ -71% |
| AmeriHealth Caritas | Medicare | $1,953.23 | ↓ -71% |
| Aetna | Medicare | $1,989.40 | ↓ -70% |
| UPMC Health Plan | Commercial | $2,352.06 | ↓ -65% |
| Aetna | Neighborhood Network | $3,863.50 | ↓ -42% |
| Aetna | Home Depot Employer Group | $4,197.52 | ↓ -37% |
| Aetna | EBR FI | $4,230.92 | ↓ -37% |
| Aetna | NBR ASO/FI | $4,286.59 | ↓ -36% |
| Cigna | New Business ASO | $4,286.59 | ↓ -36% |
| UPMC Health Plan | CHIP | $4,319.11 | ↓ -35% |
| Cigna | Commercial | $4,453.60 | ↓ -33% |
| Aetna | EBR ASO | $4,453.60 | ↓ -33% |
| InterGroup | PPO | $5,567.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $6,123.70 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $6,680.40 | ↑ +0% |
| Coventry/First Health | Commercial | $7,793.80 | ↑ +17% |
| Private Health Care Systems | PPO | $8,907.20 | ↑ +33% |
| SelectCare | Commercial | $8,907.20 | ↑ +33% |
| Humana | Commercial | $9,463.90 | ↑ +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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Ercp remove forgn body duct 43275 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,517.80 | $297.17 – $4,690.40 |
| UPMC Cole | Coudersport | $706.80 | $326.54 – $1,041.88 |
| UPMC East | Monroeville | $3,055.20 | $300.00 – $4,073.60 |
| UPMC Hamot | Erie | $4,282.80 | $297.17 – $2,630.42 |
| UPMC Jameson | New Castle | $2,626.80 | $302.41 – $2,441.54 |
| UPMC Magee | Pittsburgh | $6,045.60 | $300.00 – $1,989.40 |
| UPMC Mercy | Pittsburgh | $4,282.20 | $297.17 – $1,989.40 |
| UPMC Passavant-McCandless | Pittsburgh | $2,784.00 | $300.00 – $1,989.40 |