Consultation pathology during surgery at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$55.80
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.
$93.00
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.
$6.11 with UPMC Health Plan vs $89.17 with UPMC Work Partners — 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 | Commercial | $6.11 | ↓ -89% |
| UPMC Health Plan | CHIP | $9.91 | ↓ -82% |
| United Healthcare | Commercial | $14.84 | ↓ -73% |
| UPMC Health Plan | Managed Medicaid | $32.75 | ↓ -41% |
| Aetna | Medicaid | $33.64 | ↓ -40% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $33.65 | ↓ -40% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $34.24 | ↓ -39% |
| Geisinger | Medicaid/CHIP | $41.38 | ↓ -26% |
| PA Health & Wellness | PA Medicaid HMO | $50.73 | ↓ -9% |
| Occunet | Commercial | $56.63 | ↑ +1% |
| United Healthcare | Medicare | $56.63 | ↑ +1% |
| Aetna of PA | Medicare | $56.63 | ↑ +1% |
| Humana | Medicare | $56.63 | ↑ +1% |
| UPMC Health Plan | Managed Medicare | $59.02 | ↑ +6% |
| UPMC Health Plan | EPO Partners/Partners/Select | $59.13 | ↑ +6% |
| Highmark Wholecare (prev Gateway) | Medicare | $61.15 | ↑ +10% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $61.16 | ↑ +10% |
| AmeriHealth Caritas | Medicare | $61.16 | ↑ +10% |
| Cigna | Medicare | $61.16 | ↑ +10% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $69.75 | ↑ +25% |
| Humana | Commercial | $74.40 | ↑ +33% |
| National Provider Network | PPO | $81.84 | ↑ +47% |
| Cigna | Commercial | $87.57 | ↑ +57% |
| UPMC Work Partners | Workers Comp | $89.17 | ↑ +60% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Consultation pathology during surgery at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $78.60 | $9.91 – $111.35 |
| UPMC Community Osteopathic | Harrisburg | $78.60 | $9.91 – $111.35 |
| UPMC East | Monroeville | $159.60 | $2.73 – $212.80 |
| UPMC Hamot | Erie | $133.80 | $4.95 – $95.98 |
| UPMC Northwest | Seneca | $63.60 | $2.75 – $89.17 |
| UPMC Hanover | Hanover | $78.60 | $9.91 – $93.32 |
| UPMC Lititz | Lititz | $78.60 | $9.91 – $94.72 |
| UPMC Magee | Pittsburgh | $118.20 | $2.89 – $95.98 |