Surgical pathology level 3 gross & microscopic examination at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$236.40
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.
$394.00
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.
$13.77 with UPMC Health Plan vs $334.90 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 | Commercial | $13.77 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $18.18 | ↓ -92% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $18.18 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $20.44 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $24.51 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $25.80 | ↓ -89% |
| PA Health & Wellness | PA Medicaid HMO | $28.17 | ↓ -88% |
| Highmark BCBS of PA | Managed Care - Social Mission | $35.49 | ↓ -85% |
| UPMC Health Plan | Managed Medicare | $47.22 | ↓ -80% |
| Highmark BCBS of PA | Managed Care | $47.53 | ↓ -80% |
| UPMC Health Plan | CHIP | $48.78 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $50.94 | ↓ -78% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $52.25 | ↓ -78% |
| Aetna of PA | Medicare | $53.49 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicare | $55.02 | ↓ -77% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $55.02 | ↓ -77% |
| AmeriHealth Caritas | Medicare | $55.02 | ↓ -77% |
| Aetna | Medicare | $56.03 | ↓ -76% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $77.04 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $94.75 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Indemnity | $103.18 | ↓ -56% |
| Aetna | Neighborhood Network | $136.72 | ↓ -42% |
| Aetna | Home Depot Employer Group | $148.54 | ↓ -37% |
| Aetna | EBR FI | $149.72 | ↓ -37% |
| Aetna | NBR ASO/FI | $151.69 | ↓ -36% |
| Cigna | New Business ASO | $151.69 | ↓ -36% |
| Aetna | EBR ASO | $157.60 | ↓ -33% |
| Cigna | Commercial | $157.60 | ↓ -33% |
| InterGroup | PPO | $197.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $236.40 | ↑ +0% |
| Coventry/First Health | Commercial | $275.80 | ↑ +17% |
| SelectCare | Commercial | $315.20 | ↑ +33% |
| Private Health Care Systems | PPO | $315.20 | ↑ +33% |
| Humana | Commercial | $334.90 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 3 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $148.80 | $6.50 – $198.40 |
| UPMC Bedford | Everett | $80.40 | $13.60 – $120.60 |
| UPMC Carlisle | Carlisle | $116.40 | $8.52 – $164.90 |
| UPMC Cole | Coudersport | $132.60 | $17.36 – $176.80 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $8.52 – $164.90 |
| UPMC East | Monroeville | $156.00 | $13.42 – $208.00 |
| UPMC Hamot | Erie | $211.80 | $16.53 – $94.75 |
| UPMC Northwest | Seneca | $74.40 | $13.54 – $85.16 |