Endoscopy bowel pouch/biop at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$809.40
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.
?
What you pay up front if you don't use insurance.
$1,349.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$121.29 with UPMC Health Plan vs $1,741.00 with United Healthcare — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $121.29 | ↓ -85% |
| Aetna | Medicaid | $124.59 | ↓ -85% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $126.80 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $143.35 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $153.25 | ↓ -81% |
| PA Health & Wellness | PA Medicaid HMO | $187.91 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $325.55 | ↓ -60% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $554.65 | ↓ -31% |
| UPMC Health Plan | Commercial | $607.05 | ↓ -25% |
| Cigna | Commercial | $704.18 | ↓ -13% |
| Humana | Medicare | $869.21 | ↑ +7% |
| Aetna of PA | Medicare | $869.21 | ↑ +7% |
| United Healthcare | Medicare | $869.21 | ↑ +7% |
| UPMC Health Plan | Managed Medicare | $905.89 | ↑ +12% |
| UPMC Health Plan | EPO Partners/Partners/Select | $907.63 | ↑ +12% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↑ +16% |
| AmeriHealth Caritas | Medicare | $938.75 | ↑ +16% |
| Cigna | Medicare | $938.75 | ↑ +16% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↑ +16% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,011.75 | ↑ +25% |
| Humana | Commercial | $1,079.20 | ↑ +33% |
| Occunet | Commercial | $1,173.43 | ↑ +45% |
| National Provider Network | PPO | $1,187.12 | ↑ +47% |
| UPMC Health Plan | CHIP | $1,712.98 | ↑ +112% |
| United Healthcare | Commercial | $1,741.00 | ↑ +115% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Endoscopy bowel pouch/biop at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $2,790.00 | $121.29 – $3,720.00 |
| UPMC Hamot | Erie | $1,308.00 | $121.29 – $1,264.19 |
| UPMC Magee | Pittsburgh | $2,579.40 | $121.29 – $938.75 |
| UPMC Mercy | Pittsburgh | $808.80 | $121.29 – $956.13 |
| UPMC Passavant-McCandless | Pittsburgh | $1,600.80 | $121.29 – $956.13 |
| UPMC Presbyterian | Pittsburgh | $1,896.00 | $121.29 – $956.13 |
| UPMC Wellsboro | Wellsboro | $3,816.80 | $121.29 – $321.67 |
| UPMC Williamsport | Williamsport | $3,156.60 | $121.29 – $930.05 |