Apl(pml-rara) quant - sendout at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$790.80
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.
$1,318.00
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.
$204.89 with UPMC Work Partners vs $1,159.84 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 Work Partners | Workers Comp | $204.89 | ↓ -74% |
| United Healthcare | Medicare | $207.31 | ↓ -74% |
| Occunet | Commercial | $207.31 | ↓ -74% |
| Humana | Medicare | $207.31 | ↓ -74% |
| Aetna of PA | Medicare | $207.31 | ↓ -74% |
| Geisinger | Medicaid/CHIP | $207.31 | ↓ -74% |
| UPMC Health Plan | Managed Medicare | $216.06 | ↓ -73% |
| UPMC Health Plan | EPO Partners/Partners/Select | $216.47 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicare | $223.87 | ↓ -72% |
| AmeriHealth Caritas | Medicare | $223.89 | ↓ -72% |
| Cigna | Medicare | $223.89 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $223.89 | ↓ -72% |
| UPMC Health Plan | Managed Medicaid | $248.89 | ↓ -69% |
| Aetna | Medicaid | $255.67 | ↓ -68% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $255.74 | ↓ -68% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $260.20 | ↓ -67% |
| United Healthcare | Commercial | $282.83 | ↓ -64% |
| PA Health & Wellness | PA Medicaid HMO | $385.59 | ↓ -51% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $388.84 | ↓ -51% |
| UPMC Health Plan | Commercial | $516.41 | ↓ -35% |
| Cigna | Commercial | $538.36 | ↓ -32% |
| UPMC Health Plan | CHIP | $837.82 | ↑ +6% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $988.50 | ↑ +25% |
| Humana | Commercial | $1,054.40 | ↑ +33% |
| National Provider Network | PPO | $1,159.84 | ↑ +47% |
Visitor-reported prices
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Apl(pml-rara) quant - sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $415.80 | $204.89 – $554.40 |
| UPMC East | Monroeville | $1,189.80 | $204.89 – $1,586.40 |
| UPMC Northwest | Seneca | $2,235.60 | $188.01 – $260.20 |
| UPMC Horizon-Greenville | Greenville | $1,446.00 | $185.60 – $389.02 |
| UPMC Magee | Pittsburgh | $1,396.80 | $194.02 – $385.73 |
| UPMC Passavant-McCandless | Pittsburgh | $1,812.60 | $192.65 – $385.73 |
| UPMC Presbyterian | Pittsburgh | $765.00 | $204.89 – $385.73 |
| UPMC Wellsboro | Wellsboro | $503.20 | $204.89 – $385.59 |