Eye implant band 40 at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$97.20
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.
$162.00
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.
$31.70 with Aetna vs $4,333.29 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | Medicare | $31.70 | ↓ -67% |
| Aetna | Neighborhood Network | $56.21 | ↓ -42% |
| Aetna | Home Depot Employer Group | $61.07 | ↓ -37% |
| Aetna | EBR FI | $61.56 | ↓ -37% |
| Cigna | New Business ASO | $62.37 | ↓ -36% |
| Aetna | NBR ASO/FI | $62.37 | ↓ -36% |
| Aetna | EBR ASO | $64.80 | ↓ -33% |
| Cigna | Commercial | $64.80 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $81.00 | ↓ -17% |
| InterGroup | PPO | $81.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $89.10 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $97.20 | ↑ +0% |
| Coventry/First Health | Commercial | $113.40 | ↑ +17% |
| Private Health Care Systems | PPO | $129.60 | ↑ +33% |
| SelectCare | Commercial | $129.60 | ↑ +33% |
| Humana | Commercial | $137.70 | ↑ +42% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $246.07 | ↑ +153% |
| Highmark BCBS of PA | Managed Care - Social Mission | $920.31 | ↑ +847% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $927.68 | ↑ +854% |
| Highmark BCBS of PA | Managed Care | $1,232.57 | ↑ +1168% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,242.42 | ↑ +1178% |
| UPMC Health Plan | CHIP | $2,103.92 | ↑ +2065% |
| UPMC Health Plan | Commercial | $4,333.29 | ↑ +4358% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Eye implant band 40 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $2,530.20 | $801.23 – $3,373.60 |
| UPMC Mercy | Pittsburgh | $4,016.80 | $243.74 – $1,661.35 |
| UPMC Muncy | Muncy | $2,963.40 | $740.85 – $4,445.10 |
| UPMC Presbyterian | Pittsburgh | $2,927.40 | $246.07 – $3,401.66 |
| UPMC Wellsboro | Wellsboro | $3,584.00 | $806.40 – $4,032.00 |