Removal biliary drg cath at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$2,457.00
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.
$4,095.00
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.
$89.12 with UPMC Health Plan vs $3,480.75 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 | $89.12 | ↓ -96% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $89.12 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $120.15 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $126.48 | ↓ -95% |
| PA Health & Wellness | PA Medicaid HMO | $138.07 | ↓ -94% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $272.77 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $517.54 | ↓ -79% |
| Highmark BCBS of PA | Managed Care - Social Mission | $570.90 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $764.58 | ↓ -69% |
| UPMC Health Plan | Managed Medicare | $828.51 | ↓ -66% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $916.91 | ↓ -63% |
| Aetna of PA | Medicare | $938.54 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $965.36 | ↓ -61% |
| AmeriHealth Caritas | Medicare | $965.36 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $965.36 | ↓ -61% |
| Aetna | Medicare | $983.24 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,028.35 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,377.24 | ↓ -44% |
| Aetna | Neighborhood Network | $1,420.96 | ↓ -42% |
| Aetna | Home Depot Employer Group | $1,543.82 | ↓ -37% |
| Aetna | EBR FI | $1,556.10 | ↓ -37% |
| Cigna | New Business ASO | $1,576.58 | ↓ -36% |
| Aetna | NBR ASO/FI | $1,576.58 | ↓ -36% |
| UPMC Health Plan | Commercial | $1,604.70 | ↓ -35% |
| Aetna | EBR ASO | $1,638.00 | ↓ -33% |
| Cigna | Commercial | $1,638.00 | ↓ -33% |
| InterGroup | PPO | $2,047.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $2,457.00 | ↑ +0% |
| Coventry/First Health | Commercial | $2,866.50 | ↑ +17% |
| UPMC Health Plan | CHIP | $2,946.72 | ↑ +20% |
| SelectCare | Commercial | $3,276.00 | ↑ +33% |
| Private Health Care Systems | PPO | $3,276.00 | ↑ +33% |
| Humana | Commercial | $3,480.75 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Removal biliary drg cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,851.00 | $81.02 – $2,468.00 |
| UPMC Carlisle | Carlisle | $1,663.20 | $102.90 – $2,356.20 |
| UPMC Community Osteopathic | Harrisburg | $1,663.20 | $109.38 – $2,946.72 |
| UPMC East | Monroeville | $3,018.60 | $89.12 – $4,024.80 |
| UPMC Hamot | Erie | $2,349.00 | $89.12 – $1,300.05 |
| UPMC Northwest | Seneca | $1,176.00 | $89.12 – $938.54 |
| UPMC Hanover | Hanover | $1,663.20 | $102.90 – $1,433.04 |
| UPMC Lititz | Lititz | $1,663.20 | $102.90 – $1,440.78 |