healthcosts.net
Lower Back (Lumbar Spine) CT scan (with contrast) at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$2,836.20
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.
?
What you pay up front if you don't use insurance.
$4,727.00
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.
$165.60 with UPMC Health Plan vs $4,017.95 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 | $165.60 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $165.60 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $223.27 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $235.02 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $256.57 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $315.59 | ↓ -89% |
| UPMC Health Plan | Commercial | $337.54 | ↓ -88% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $349.26 | ↓ -88% |
| Aetna of PA | Medicare | $357.50 | ↓ -87% |
| AmeriHealth Caritas | Medicare | $367.72 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicare | $367.72 | ↓ -87% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $367.72 | ↓ -87% |
| Aetna | Medicare | $374.53 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $379.18 | ↓ -87% |
| Highmark BCBS of PA | Managed Care - Social Mission | $793.63 | ↓ -72% |
| UPMC Work Partners | Workers Comp | $814.85 | ↓ -71% |
| Highmark BCBS of PA | Managed Care | $1,062.87 | ↓ -63% |
| UPMC Health Plan | CHIP | $1,195.38 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,429.54 | ↓ -50% |
| Aetna | Neighborhood Network | $1,640.27 | ↓ -42% |
| Aetna | Home Depot Employer Group | $1,782.08 | ↓ -37% |
| Aetna | EBR FI | $1,796.26 | ↓ -37% |
| Aetna | NBR ASO/FI | $1,819.89 | ↓ -36% |
| Cigna | New Business ASO | $1,819.89 | ↓ -36% |
| Cigna | Commercial | $1,890.80 | ↓ -33% |
| Aetna | EBR ASO | $1,890.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,914.55 | ↓ -32% |
| InterGroup | PPO | $2,363.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $2,836.20 | ↑ +0% |
| Coventry/First Health | Commercial | $3,308.90 | ↑ +17% |
| Private Health Care Systems | PPO | $3,781.60 | ↑ +33% |
| SelectCare | Commercial | $3,781.60 | ↑ +33% |
| Humana | Commercial | $4,017.95 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) CT scan (with contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $2,917.20 | $165.60 – $3,889.60 |
| UPMC Passavant-McCandless | Pittsburgh | $2,654.40 | $165.60 – $3,760.40 |
| UPMC Hamot | Erie | $2,052.60 | $140.66 – $2,394.70 |
| UPMC Carlisle | Carlisle | $1,424.40 | $123.14 – $2,017.90 |
| UPMC Altoona | Altoona | $1,405.80 | $94.00 – $1,874.40 |
| UPMC Bedford | Everett | $957.60 | $122.85 – $1,436.40 |
| UPMC Cole | Coudersport | $961.20 | $158.08 – $1,281.60 |
| UPMC Community Osteopathic | Harrisburg | $1,424.40 | $123.14 – $2,017.90 |