Treat toe fracture at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$4,408.20
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.
$7,347.00
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.
$525.62 with UPMC Work Partners vs $6,244.95 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 Work Partners | Workers Comp | $525.62 | ↓ -88% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $844.93 | ↓ -81% |
| UPMC Health Plan | Commercial | $945.91 | ↓ -79% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,768.44 | ↓ -60% |
| Highmark BCBS of PA | Managed Care | $2,368.38 | ↓ -46% |
| Aetna | Neighborhood Network | $2,549.41 | ↓ -42% |
| UPMC Health Plan | CHIP | $2,636.42 | ↓ -40% |
| Aetna | Home Depot Employer Group | $2,769.82 | ↓ -37% |
| Aetna | EBR FI | $2,791.86 | ↓ -37% |
| Cigna | New Business ASO | $2,828.59 | ↓ -36% |
| Aetna | NBR ASO/FI | $2,828.59 | ↓ -36% |
| UPMC Health Plan | Managed Medicare | $2,867.23 | ↓ -35% |
| Aetna | EBR ASO | $2,938.80 | ↓ -33% |
| Cigna | Commercial | $2,938.80 | ↓ -33% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,173.16 | ↓ -28% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,185.44 | ↓ -28% |
| Aetna of PA | Medicare | $3,248.02 | ↓ -26% |
| AmeriHealth Caritas | Medicare | $3,340.82 | ↓ -24% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,340.82 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,340.82 | ↓ -24% |
| Aetna | Medicare | $3,402.68 | ↓ -23% |
| InterGroup | PPO | $3,673.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $4,040.85 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,266.17 | ↓ -3% |
| Cigna Behavioral Health | Commercial | $4,408.20 | ↑ +0% |
| Coventry/First Health | Commercial | $5,142.90 | ↑ +17% |
| SelectCare | Commercial | $5,877.60 | ↑ +33% |
| Private Health Care Systems | PPO | $5,877.60 | ↑ +33% |
| Humana | Commercial | $6,244.95 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Treat toe fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $4,757.40 | $525.62 – $6,343.20 |
| UPMC Wellsboro | Wellsboro | $6,191.20 | $540.62 – $993.28 |
| UPMC Altoona | Altoona | not published | $540.62 – $3,340.82 |
| UPMC Cole | Coudersport | not published | $540.62 – $2,636.42 |
| UPMC Kane | Kane | not published | $540.62 – $2,365.38 |
| UPMC Williamsport | Williamsport | not published | $525.62 – $3,340.82 |
| WellSpan Chambersburg Hospital | Chambersburg | not published | $970.00 – $14,922.27 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | not published | $970.00 – $1,101.92 |