healthcosts.net
Lower Back (Lumbar Spine) X-ray at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$215.40
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.
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What you pay up front if you don't use insurance.
$359.00
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.
$25.88 with United Healthcare Community Plan for Families vs $315.92 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 | $25.88 | ↓ -88% |
| Aetna of PA | Medicare | $34.80 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $35.78 | ↓ -83% |
| Aetna | Medicaid | $36.76 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $42.29 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $43.45 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $45.21 | ↓ -79% |
| PA Health & Wellness | PA Medicaid HMO | $55.44 | ↓ -74% |
| UPMC Health Plan | Commercial | $76.14 | ↓ -65% |
| UPMC Work Partners | Workers Comp | $87.60 | ↓ -59% |
| Humana | Medicare | $101.38 | ↓ -53% |
| United Healthcare | Medicare | $101.38 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $105.66 | ↓ -51% |
| UPMC Health Plan | EPO Partners/Partners/Select | $105.86 | ↓ -51% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -49% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -49% |
| Cigna | Medicare | $109.49 | ↓ -49% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -49% |
| UPMC Health Plan | CHIP | $123.54 | ↓ -43% |
| Occunet | Commercial | $126.72 | ↓ -41% |
| Cigna | Commercial | $251.90 | ↑ +17% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $269.25 | ↑ +25% |
| Humana | Commercial | $287.20 | ↑ +33% |
| United Healthcare | Commercial | $313.00 | ↑ +45% |
| National Provider Network | PPO | $315.92 | ↑ +47% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $436.20 | $33.98 – $581.60 |
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $34.28 – $594.15 |
| UPMC Hamot | Erie | $438.00 | $25.96 – $511.00 |
| UPMC Carlisle | Carlisle | $262.80 | $29.48 – $372.30 |
| UPMC Altoona | Altoona | $208.80 | $22.50 – $278.40 |
| UPMC Bedford | Everett | $115.80 | $34.16 – $173.70 |
| UPMC Cole | Coudersport | $171.00 | $34.16 – $228.00 |
| UPMC Community Osteopathic | Harrisburg | $272.40 | $29.48 – $372.30 |