Ghs closed tx bimalleolar fracture w/manip at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$4,526.40
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.
$7,544.00
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.
$550.23 with Highmark BCBS of PA vs $6,412.40 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 | $550.23 | ↓ -88% |
| UPMC Health Plan | Commercial | $621.51 | ↓ -86% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,151.62 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $1,254.03 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $1,414.26 | ↓ -69% |
| Highmark BCBS of PA | Managed Care | $1,542.31 | ↓ -66% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,565.17 | ↓ -65% |
| Aetna of PA | Medicare | $1,602.09 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,647.86 | ↓ -64% |
| AmeriHealth Caritas | Medicare | $1,647.86 | ↓ -64% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,647.86 | ↓ -64% |
| Aetna | Medicare | $1,678.38 | ↓ -63% |
| UPMC Health Plan | CHIP | $1,732.25 | ↓ -62% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,074.38 | ↓ -54% |
| Aetna | Neighborhood Network | $2,617.77 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,778.17 | ↓ -39% |
| Aetna | Home Depot Employer Group | $2,844.09 | ↓ -37% |
| Aetna | EBR FI | $2,866.72 | ↓ -37% |
| Aetna | NBR ASO/FI | $2,904.44 | ↓ -36% |
| Cigna | New Business ASO | $2,904.44 | ↓ -36% |
| Aetna | EBR ASO | $3,017.60 | ↓ -33% |
| Cigna | Commercial | $3,017.60 | ↓ -33% |
| InterGroup | PPO | $3,772.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $4,149.20 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $4,526.40 | ↑ +0% |
| Coventry/First Health | Commercial | $5,280.80 | ↑ +17% |
| Private Health Care Systems | PPO | $6,035.20 | ↑ +33% |
| SelectCare | Commercial | $6,035.20 | ↑ +33% |
| Humana | Commercial | $6,412.40 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs closed tx bimalleolar fracture w/manip at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,275.20 | $545.04 – $3,033.60 |
| UPMC Bedford | Everett | $1,214.40 | $550.51 – $1,821.60 |
| UPMC Carlisle | Carlisle | $2,055.00 | $469.23 – $2,911.25 |
| UPMC Cole | Coudersport | $1,479.00 | $107.55 – $1,114.22 |
| UPMC Community Osteopathic | Harrisburg | $2,055.00 | $685.00 – $2,911.25 |
| UPMC East | Monroeville | $2,281.20 | $550.23 – $3,041.60 |
| UPMC Hamot | Erie | $2,337.60 | $545.04 – $2,219.16 |
| UPMC Northwest | Seneca | $3,032.40 | $818.30 – $1,647.86 |