Passy muir valve metal trach at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$198.60
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.
$331.00
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.
$78.21 with Aetna vs $986.15 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 | $78.21 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicaid | $82.75 | ↓ -58% |
| Aetna | Neighborhood Network | $114.86 | ↓ -42% |
| Aetna | Home Depot Employer Group | $124.79 | ↓ -37% |
| Aetna | EBR FI | $125.78 | ↓ -37% |
| Cigna | New Business ASO | $127.44 | ↓ -36% |
| Aetna | NBR ASO/FI | $127.44 | ↓ -36% |
| Aetna | EBR ASO | $132.40 | ↓ -33% |
| Cigna | Commercial | $132.40 | ↓ -33% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $157.36 | ↓ -21% |
| InterGroup | PPO | $165.50 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $165.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $182.05 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $198.60 | ↑ +0% |
| UPMC Work Partners | Workers Comp | $222.54 | ↑ +12% |
| Coventry/First Health | Commercial | $231.70 | ↑ +17% |
| SelectCare | Commercial | $264.80 | ↑ +33% |
| Private Health Care Systems | PPO | $264.80 | ↑ +33% |
| Humana | Commercial | $281.35 | ↑ +42% |
| UPMC Health Plan | CHIP | $478.80 | ↑ +141% |
| Highmark BCBS of PA | Managed Care - Social Mission | $588.55 | ↑ +196% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $593.27 | ↑ +199% |
| Highmark BCBS of PA | Managed Care | $788.25 | ↑ +297% |
| Highmark BCBS of PA | Commercial - Indemnity | $794.55 | ↑ +300% |
| UPMC Health Plan | Commercial | $986.15 | ↑ +397% |
Visitor-reported prices
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Passy muir valve metal trach at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $289.80 | $91.77 – $478.80 |
| UPMC Cole | Coudersport | $484.20 | $153.33 – $645.60 |
| UPMC East | Monroeville | $1,273.20 | $157.36 – $1,697.60 |
| UPMC Hamot | Erie | $367.20 | $155.88 – $222.54 |
| UPMC Northwest | Seneca | $346.20 | $222.54 – $579.39 |
| UPMC Magee | Pittsburgh | $304.20 | $78.21 – $478.80 |
| UPMC Mercy | Pittsburgh | $241.20 | $155.88 – $378.08 |
| UPMC Muncy | Muncy | $289.80 | $96.00 – $238.07 |