Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$100.20
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.
$167.00
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.
$8.41 with United Healthcare Community Plan for Families vs $146.96 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $8.41 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $11.84 | ↓ -88% |
| Occunet | Commercial | $11.98 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $11.98 | ↓ -88% |
| Humana | Medicare | $11.98 | ↓ -88% |
| Aetna of PA | Medicare | $11.98 | ↓ -88% |
| United Healthcare | Medicare | $11.98 | ↓ -88% |
| UPMC Health Plan | Managed Medicare | $12.49 | ↓ -88% |
| UPMC Health Plan | EPO Partners/Partners/Select | $12.51 | ↓ -88% |
| AmeriHealth Caritas | Medicare | $12.94 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.94 | ↓ -87% |
| Cigna | Medicare | $12.94 | ↓ -87% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12.94 | ↓ -87% |
| United Healthcare | Commercial | $16.76 | ↓ -83% |
| Cigna | Commercial | $31.12 | ↓ -69% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $31.99 | ↓ -68% |
| UPMC Health Plan | Commercial | $49.19 | ↓ -51% |
| UPMC Health Plan | CHIP | $79.80 | ↓ -20% |
| PA Health & Wellness | PA Medicaid HMO | $91.85 | ↓ -8% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $125.25 | ↑ +25% |
| Humana | Commercial | $133.60 | ↑ +33% |
| National Provider Network | PPO | $146.96 | ↑ +47% |
Visitor-reported prices
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Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $151.20 | $11.84 – $201.60 |
| UPMC Bedford | Everett | $72.00 | $4.32 – $108.00 |
| UPMC Carlisle | Carlisle | $43.80 | $6.59 – $62.05 |
| UPMC Cole | Coudersport | $70.20 | $7.79 – $93.60 |
| UPMC Community Osteopathic | Harrisburg | $43.80 | $9.58 – $79.80 |
| UPMC East | Monroeville | $126.00 | $11.84 – $168.00 |
| UPMC Hamot | Erie | $221.40 | $11.84 – $31.43 |
| UPMC Northwest | Seneca | $108.00 | $10.86 – $12.94 |