Replace duod/jej tube perc at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$1,894.80
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.
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What you pay up front if you don't use insurance.
$3,158.00
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.
$77.36 with United Healthcare Community Plan for Families vs $7,122.80 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $77.36 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $77.36 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $104.30 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $109.79 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $119.86 | ↓ -94% |
| UPMC Health Plan | Commercial | $749.43 | ↓ -60% |
| UPMC Health Plan | Managed Medicare | $828.51 | ↓ -56% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $916.91 | ↓ -52% |
| Aetna of PA | Medicare | $938.54 | ↓ -50% |
| AmeriHealth Caritas | Medicare | $965.36 | ↓ -49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $965.36 | ↓ -49% |
| Highmark Wholecare (prev Gateway) | Medicare | $965.36 | ↓ -49% |
| Aetna | Medicare | $983.24 | ↓ -48% |
| Aetna | Neighborhood Network | $1,095.83 | ↓ -42% |
| Aetna | Home Depot Employer Group | $1,190.57 | ↓ -37% |
| Aetna | EBR FI | $1,200.04 | ↓ -37% |
| Cigna | New Business ASO | $1,215.83 | ↓ -36% |
| Aetna | NBR ASO/FI | $1,215.83 | ↓ -36% |
| UPMC Work Partners | Workers Comp | $1,219.54 | ↓ -36% |
| Cigna | Commercial | $1,263.20 | ↓ -33% |
| Aetna | EBR ASO | $1,263.20 | ↓ -33% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,410.70 | ↓ -26% |
| InterGroup | PPO | $1,579.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $1,894.80 | ↑ +0% |
| UPMC Health Plan | CHIP | $2,088.80 | ↑ +10% |
| Coventry/First Health | Commercial | $2,210.60 | ↑ +17% |
| Private Health Care Systems | PPO | $2,526.40 | ↑ +33% |
| SelectCare | Commercial | $2,526.40 | ↑ +33% |
| Humana | Commercial | $2,684.30 | ↑ +42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,952.58 | ↑ +56% |
| Highmark BCBS of PA | Managed Care | $3,954.24 | ↑ +109% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,318.40 | ↑ +181% |
| Highmark BCBS of PA | Commercial - Indemnity | $7,122.80 | ↑ +276% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Replace duod/jej tube perc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,044.40 | $70.33 – $4,059.20 |
| UPMC Carlisle | Carlisle | $4,216.80 | $89.32 – $5,973.80 |
| UPMC Community Osteopathic | Harrisburg | $4,216.80 | $94.95 – $5,973.80 |
| UPMC East | Monroeville | $5,850.00 | $77.36 – $7,800.00 |
| UPMC Hamot | Erie | $2,997.00 | $77.36 – $1,397.39 |
| UPMC Northwest | Seneca | $2,860.20 | $77.36 – $1,219.54 |
| UPMC Hanover | Hanover | $4,216.80 | $89.32 – $1,433.04 |
| UPMC Jameson | New Castle | $6,743.40 | $77.36 – $1,422.05 |