M/phmtrc alys ishquant/semiq at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$75.00
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.
$125.00
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.
$25.14 with Highmark BCBS of PA vs $110.55 with Cigna — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $25.14 | ↓ -66% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $33.64 | ↓ -55% |
| United Healthcare | Commercial | $39.02 | ↓ -48% |
| UPMC Health Plan | CHIP | $43.75 | ↓ -42% |
| UPMC Health Plan | Managed Medicaid | $50.40 | ↓ -33% |
| Aetna | Medicaid | $51.78 | ↓ -31% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $51.79 | ↓ -31% |
| Aetna of PA | Medicare | $54.41 | ↓ -27% |
| UPMC Health Plan | Commercial | $56.25 | ↓ -25% |
| Highmark Wholecare (prev Gateway) | Medicare | $62.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $63.69 | ↓ -15% |
| PA Health & Wellness | PA Medicaid HMO | $78.09 | ↑ +4% |
| UPMC Work Partners | Workers Comp | $78.53 | ↑ +5% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $93.75 | ↑ +25% |
| Humana | Commercial | $100.00 | ↑ +33% |
| National Provider Network | PPO | $110.00 | ↑ +47% |
| Cigna | Commercial | $110.55 | ↑ +47% |
Visitor-reported prices
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M/phmtrc alys ishquant/semiq at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $123.00 | $24.70 – $164.00 |
| UPMC Bedford | Everett | $155.40 | $45.82 – $233.10 |
| UPMC Carlisle | Carlisle | $177.00 | $38.32 – $250.75 |
| UPMC Cole | Coudersport | $474.60 | $48.11 – $632.80 |
| UPMC Community Osteopathic | Harrisburg | $177.00 | $38.32 – $250.75 |
| UPMC East | Monroeville | $109.80 | $24.94 – $146.40 |
| UPMC Hamot | Erie | $138.60 | $24.70 – $149.26 |
| UPMC Northwest | Seneca | $152.40 | $50.40 – $78.53 |