Repair lip full thkns >one-half vert height/cmplx at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$4,060.80
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.
$6,768.00
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.
$405.09 with UPMC Health Plan vs $5,752.80 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 | $405.09 | ↓ -90% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $405.09 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $546.13 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $574.89 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $627.59 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $844.93 | ↓ -79% |
| UPMC Health Plan | Commercial | $952.58 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $1,308.99 | ↓ -68% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,448.66 | ↓ -64% |
| Aetna of PA | Medicare | $1,482.83 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,525.20 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,525.20 | ↓ -62% |
| AmeriHealth Caritas | Medicare | $1,525.20 | ↓ -62% |
| Aetna | Medicare | $1,553.44 | ↓ -62% |
| UPMC Work Partners | Workers Comp | $1,600.15 | ↓ -61% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,768.44 | ↓ -56% |
| Aetna | Neighborhood Network | $2,348.50 | ↓ -42% |
| Highmark BCBS of PA | Managed Care | $2,368.38 | ↓ -42% |
| Aetna | Home Depot Employer Group | $2,551.54 | ↓ -37% |
| Aetna | EBR FI | $2,571.84 | ↓ -37% |
| Cigna | New Business ASO | $2,605.68 | ↓ -36% |
| Aetna | NBR ASO/FI | $2,605.68 | ↓ -36% |
| UPMC Health Plan | CHIP | $2,655.02 | ↓ -35% |
| Aetna | EBR ASO | $2,707.20 | ↓ -33% |
| Cigna | Commercial | $2,707.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,185.44 | ↓ -22% |
| InterGroup | PPO | $3,384.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $4,060.80 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,266.17 | ↑ +5% |
| Coventry/First Health | Commercial | $4,737.60 | ↑ +17% |
| SelectCare | Commercial | $5,414.40 | ↑ +33% |
| Private Health Care Systems | PPO | $5,414.40 | ↑ +33% |
| Humana | Commercial | $5,752.80 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Repair lip full thkns >one-half vert height/cmplx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,046.00 | $467.17 – $2,898.50 |
| UPMC Community Osteopathic | Harrisburg | $2,046.00 | $467.69 – $2,898.50 |
| UPMC Hamot | Erie | $4,856.40 | $405.09 – $2,053.97 |
| UPMC Hanover | Hanover | $2,046.00 | $467.69 – $2,264.11 |
| UPMC Jameson | New Castle | $3,645.60 | $405.09 – $1,906.50 |
| UPMC Lititz | Lititz | $2,046.00 | $467.69 – $2,276.34 |
| UPMC Memorial | York | $2,046.00 | $467.69 – $2,272.64 |
| UPMC Mercy | Pittsburgh | $3,486.60 | $405.09 – $1,601.90 |