Kit lead specify 5-6-5 at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$7,176.60
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.
$11,961.00
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.
$303.60 with Occunet vs $13,170.92 with UPMC Health Plan — 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 |
|---|---|---|---|
| Occunet | Commercial | $303.60 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $333.96 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $333.96 | ↓ -95% |
| United Healthcare | Commercial | $353.19 | ↓ -95% |
| UPMC Health Plan | Commercial | $455.40 | ↓ -94% |
| Cigna | Commercial | $477.66 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $506.00 | ↓ -93% |
| Aetna of PA | Medicare | $582.60 | ↓ -92% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $759.00 | ↓ -89% |
| Humana | Commercial | $809.60 | ↓ -89% |
| National Provider Network | PPO | $890.56 | ↓ -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 | $2,191.59 | ↓ -69% |
| UPMC Health Plan | CHIP | $13,170.92 | ↑ +84% |
| UPMC Health Plan | Managed Medicaid | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Aetna | Medicaid | not published by hospital | — |
Visitor-reported prices
Comments
Kit lead specify 5-6-5 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $25,039.80 | $37.62 – $13,170.92 |
| UPMC Bedford | Everett | $7,272.00 | $38.00 – $13,170.92 |
| UPMC Cole | Coudersport | $18,036.00 | $5,711.40 – $24,048.00 |
| UPMC East | Monroeville | $21,221.40 | $133.00 – $13,170.92 |
| UPMC Hamot | Erie | $24,616.20 | $2,153.59 – $2,153.59 |
| UPMC Northwest | Seneca | $7,816.20 | $5,589.39 – $15,937.99 |
| UPMC Horizon-Greenville | Greenville | $11,638.80 | $5,488.59 – $13,170.92 |
| UPMC Kane | Kane | $2,910.60 | $9,698.74 – $9,698.74 |