Bld prd mix at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$109.20
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.
$182.00
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.
$2.44 with Cigna vs $176.44 with Cigna — 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 |
|---|---|---|---|
| Cigna | Commercial | $2.44 | ↓ -98% |
| United Healthcare | Commercial | $12.91 | ↓ -88% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $48.60 | ↓ -55% |
| UPMC Health Plan | Commercial | $80.39 | ↓ -26% |
| PA Health & Wellness | PA Medicaid HMO | $100.10 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $100.10 | ↓ -8% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $110.31 | ↑ +1% |
| UPMC Health Plan | CHIP | $130.42 | ↑ +19% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $136.50 | ↑ +25% |
| Humana | Commercial | $145.60 | ↑ +33% |
| National Provider Network | PPO | $160.16 | ↑ +47% |
| United Healthcare | Medicare | $163.37 | ↑ +50% |
| Humana | Medicare | $163.37 | ↑ +50% |
| Aetna of PA | Medicare | $163.37 | ↑ +50% |
| Occunet | Commercial | $163.37 | ↑ +50% |
| UPMC Health Plan | Managed Medicare | $170.26 | ↑ +56% |
| UPMC Health Plan | EPO Partners/Partners/Select | $170.59 | ↑ +56% |
| Highmark Wholecare (prev Gateway) | Medicare | $176.42 | ↑ +62% |
| AmeriHealth Caritas | Medicare | $176.44 | ↑ +62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $176.44 | ↑ +62% |
| Cigna | Medicare | $176.44 | ↑ +62% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Bld prd mix at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $201.60 | $46.03 – $285.60 |
| UPMC Community Osteopathic | Harrisburg | $201.60 | $67.20 – $285.60 |
| UPMC East | Monroeville | $369.60 | $35.88 – $492.80 |
| UPMC Hanover | Hanover | $201.60 | $88.20 – $261.92 |
| UPMC Horizon-Greenville | Greenville | $109.20 | $36.33 – $176.44 |
| UPMC Lititz | Lititz | $201.60 | $88.20 – $263.33 |
| UPMC Magee | Pittsburgh | $187.20 | $37.97 – $179.71 |
| UPMC McKeesport | Mckeesport | $236.40 | $36.83 – $179.71 |