Treatment of thigh fracture at UPMC McKeesport
1500 Fifth Avenue, Mckeesport, PA · UPMC · · NPI 104370353
$2,829.60
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.
$4,716.00
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.
$348.70 with United Healthcare Community Plan for Families vs $4,008.60 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $348.70 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $348.70 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $470.11 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $494.87 | ↓ -83% |
| PA Health & Wellness | PA Medicaid HMO | $540.23 | ↓ -81% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $550.23 | ↓ -81% |
| UPMC Health Plan | Commercial | $620.72 | ↓ -78% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,151.62 | ↓ -59% |
| UPMC Health Plan | Managed Medicare | $1,414.26 | ↓ -50% |
| Highmark BCBS of PA | Managed Care | $1,542.31 | ↓ -45% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,565.17 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $1,570.96 | ↓ -44% |
| Aetna of PA | Medicare | $1,602.09 | ↓ -43% |
| Aetna | Neighborhood Network | $1,636.45 | ↓ -42% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,647.86 | ↓ -42% |
| AmeriHealth Caritas | Medicare | $1,647.86 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,647.86 | ↓ -42% |
| Aetna | Medicare | $1,678.38 | ↓ -41% |
| UPMC Health Plan | CHIP | $1,730.06 | ↓ -39% |
| Aetna | Home Depot Employer Group | $1,777.93 | ↓ -37% |
| Aetna | EBR FI | $1,792.08 | ↓ -37% |
| Aetna | NBR ASO/FI | $1,815.66 | ↓ -36% |
| Cigna | New Business ASO | $1,815.66 | ↓ -36% |
| Aetna | EBR ASO | $1,886.40 | ↓ -33% |
| Cigna | Commercial | $1,886.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,074.38 | ↓ -27% |
| InterGroup | PPO | $2,358.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,778.17 | ↓ -2% |
| Cigna Behavioral Health | Commercial | $2,829.60 | ↑ +0% |
| Coventry/First Health | Commercial | $3,301.20 | ↑ +17% |
| SelectCare | Commercial | $3,772.80 | ↑ +33% |
| Private Health Care Systems | PPO | $3,772.80 | ↑ +33% |
| Humana | Commercial | $4,008.60 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of thigh fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,275.20 | $317.00 – $3,033.60 |
| UPMC Carlisle | Carlisle | $2,055.00 | $402.59 – $2,911.25 |
| UPMC Community Osteopathic | Harrisburg | $2,055.00 | $402.59 – $2,911.25 |
| UPMC East | Monroeville | $2,790.00 | $348.70 – $3,720.00 |
| UPMC Hamot | Erie | $2,334.00 | $348.70 – $2,219.16 |
| UPMC Northwest | Seneca | $3,352.80 | $348.70 – $1,602.09 |
| UPMC Hanover | Hanover | $2,055.00 | $402.59 – $2,446.19 |
| UPMC Horizon-Greenville | Greenville | $4,482.60 | $348.70 – $1,647.86 |