Ghs simple repair 7.6 - 12.5 cm - 12015 at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$951.00
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.
?
What you pay up front if you don't use insurance.
$1,585.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$67.65 with UPMC Health Plan vs $1,347.25 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $67.65 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $67.65 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $91.20 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $96.01 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $104.81 | ↓ -89% |
| UPMC Health Plan | Managed Medicare | $175.59 | ↓ -82% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $194.33 | ↓ -80% |
| Aetna of PA | Medicare | $198.91 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $204.60 | ↓ -78% |
| AmeriHealth Caritas | Medicare | $204.60 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $204.60 | ↓ -78% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $206.41 | ↓ -78% |
| Aetna | Medicare | $208.38 | ↓ -78% |
| UPMC Health Plan | Commercial | $228.53 | ↓ -76% |
| Highmark BCBS of PA | Managed Care - Social Mission | $432.02 | ↓ -55% |
| UPMC Work Partners | Workers Comp | $446.19 | ↓ -53% |
| Aetna | Neighborhood Network | $550.00 | ↓ -42% |
| Highmark BCBS of PA | Managed Care | $578.59 | ↓ -39% |
| Aetna | Home Depot Employer Group | $597.54 | ↓ -37% |
| Aetna | EBR FI | $602.30 | ↓ -37% |
| Aetna | NBR ASO/FI | $610.23 | ↓ -36% |
| Cigna | New Business ASO | $610.23 | ↓ -36% |
| Aetna | EBR ASO | $634.00 | ↓ -33% |
| Cigna | Commercial | $634.00 | ↓ -33% |
| UPMC Health Plan | CHIP | $636.94 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $778.20 | ↓ -18% |
| InterGroup | PPO | $792.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $951.00 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,042.22 | ↑ +10% |
| Coventry/First Health | Commercial | $1,109.50 | ↑ +17% |
| Private Health Care Systems | PPO | $1,268.00 | ↑ +33% |
| SelectCare | Commercial | $1,268.00 | ↑ +33% |
| Humana | Commercial | $1,347.25 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 7.6 - 12.5 cm - 12015 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $819.60 | $61.50 – $1,092.80 |
| UPMC Bedford | Everett | $454.20 | $64.58 – $681.30 |
| UPMC Carlisle | Carlisle | $808.20 | $78.11 – $1,144.95 |
| UPMC Cole | Coudersport | $765.00 | $64.58 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $808.20 | $78.11 – $1,144.95 |
| UPMC East | Monroeville | $856.80 | $67.65 – $1,142.40 |
| UPMC Hamot | Erie | $857.40 | $67.65 – $446.19 |
| UPMC Northwest | Seneca | $610.80 | $67.65 – $419.77 |