Insertion of new/replacement ppm w/transvenous electrode(s) ventricular at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$18,426.00
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.
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What you pay up front if you don't use insurance.
$30,710.00
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.
$507.30 with UPMC Health Plan vs $26,103.50 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $507.30 | ↓ -97% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $507.30 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $683.93 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $719.95 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $785.94 | ↓ -96% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $909.58 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $1,866.23 | ↓ -90% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,903.74 | ↓ -90% |
| UPMC Health Plan | Commercial | $2,052.78 | ↓ -89% |
| Highmark BCBS of PA | Managed Care | $2,549.58 | ↓ -86% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,429.15 | ↓ -81% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,592.58 | ↓ -75% |
| UPMC Health Plan | CHIP | $5,721.46 | ↓ -69% |
| UPMC Health Plan | Managed Medicare | $9,248.09 | ↓ -50% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10,234.86 | ↓ -44% |
| Aetna of PA | Medicare | $10,476.31 | ↓ -43% |
| Aetna | Neighborhood Network | $10,656.37 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicare | $10,775.64 | ↓ -42% |
| AmeriHealth Caritas | Medicare | $10,775.64 | ↓ -42% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,775.64 | ↓ -42% |
| Aetna | Medicare | $10,975.18 | ↓ -40% |
| Aetna | Home Depot Employer Group | $11,577.67 | ↓ -37% |
| Aetna | EBR FI | $11,669.80 | ↓ -37% |
| Aetna | NBR ASO/FI | $11,823.35 | ↓ -36% |
| Cigna | New Business ASO | $11,823.35 | ↓ -36% |
| Aetna | EBR ASO | $12,284.00 | ↓ -33% |
| Cigna | Commercial | $12,284.00 | ↓ -33% |
| InterGroup | PPO | $15,355.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $18,426.00 | ↑ +0% |
| Coventry/First Health | Commercial | $21,497.00 | ↑ +17% |
| SelectCare | Commercial | $24,568.00 | ↑ +33% |
| Private Health Care Systems | PPO | $24,568.00 | ↑ +33% |
| Humana | Commercial | $26,103.50 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,138.20 | $461.18 – $5,517.60 |
| UPMC Carlisle | Carlisle | $24,630.00 | $585.70 – $34,892.50 |
| UPMC Cole | Coudersport | $990.00 | $457.38 – $1,954.88 |
| UPMC Community Osteopathic | Harrisburg | $24,630.00 | $585.70 – $34,892.50 |
| UPMC East | Monroeville | $3,774.00 | $507.30 – $10,476.31 |
| UPMC Hamot | Erie | $10,378.80 | $507.30 – $14,511.47 |
| UPMC Hanover | Hanover | $24,630.00 | $585.70 – $15,996.05 |
| UPMC Jameson | New Castle | $17,091.00 | $507.30 – $13,469.54 |