Anl sp inf pmp w/mdreprg&fil at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$912.00
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.
$1,520.00
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.
$40.46 with UPMC Health Plan vs $1,337.60 with National Provider Network — 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 | Managed Medicaid | $40.46 | ↓ -96% |
| Aetna | Medicaid | $41.56 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $42.30 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $47.82 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $51.12 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $62.68 | ↓ -93% |
| Cigna | Commercial | $91.23 | ↓ -90% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $158.29 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $180.04 | ↓ -80% |
| United Healthcare | Medicare | $285.93 | ↓ -69% |
| Humana | Medicare | $285.93 | ↓ -69% |
| Aetna of PA | Medicare | $285.93 | ↓ -69% |
| UPMC Health Plan | Managed Medicare | $298.00 | ↓ -67% |
| UPMC Health Plan | EPO Partners/Partners/Select | $298.57 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicare | $308.78 | ↓ -66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $308.80 | ↓ -66% |
| AmeriHealth Caritas | Medicare | $308.80 | ↓ -66% |
| Cigna | Medicare | $308.80 | ↓ -66% |
| Occunet | Commercial | $386.01 | ↓ -58% |
| United Healthcare | Commercial | $581.00 | ↓ -36% |
| UPMC Health Plan | Commercial | $684.00 | ↓ -25% |
| UPMC Health Plan | CHIP | $1,053.98 | ↑ +16% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,140.00 | ↑ +25% |
| Humana | Commercial | $1,216.00 | ↑ +33% |
| National Provider Network | PPO | $1,337.60 | ↑ +47% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Anl sp inf pmp w/mdreprg&fil at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $97.20 | $19.68 – $1,041.88 |
| UPMC Magee | Pittsburgh | $909.60 | $40.46 – $308.80 |
| UPMC Mercy | Pittsburgh | $639.00 | $40.46 – $314.52 |
| UPMC Presbyterian | Pittsburgh | $1,131.00 | $40.46 – $314.52 |
| UPMC St. Margaret | Pittsburgh | $793.20 | $40.46 – $314.52 |
| UPMC Williamsport | Williamsport | $1,135.80 | $40.46 – $305.95 |
| Uniontown Hospital | Uniontown | $353.00 | $34.74 – $618.30 |
| UPMC Lititz | Lititz | not published | $46.71 – $460.88 |