Njx interlaminar lmbr/sac at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$1,460.40
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.
$2,434.00
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.
$81.77 with UPMC Health Plan vs $2,482.82 with UPMC Health Plan — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $81.77 | ↓ -94% |
| Aetna | Medicaid | $84.00 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $96.65 | ↓ -93% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $99.55 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $103.33 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $126.69 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $198.52 | ↓ -86% |
| United Healthcare | Medicare | $848.78 | ↓ -42% |
| Aetna of PA | Medicare | $848.78 | ↓ -42% |
| Humana | Medicare | $848.78 | ↓ -42% |
| United Healthcare | Commercial | $882.00 | ↓ -40% |
| UPMC Health Plan | Managed Medicare | $884.60 | ↓ -39% |
| UPMC Health Plan | EPO Partners/Partners/Select | $886.30 | ↓ -39% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $892.40 | ↓ -39% |
| Highmark Wholecare (prev Gateway) | Medicare | $916.60 | ↓ -37% |
| AmeriHealth Caritas | Medicare | $916.68 | ↓ -37% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $916.68 | ↓ -37% |
| Cigna | Medicare | $916.68 | ↓ -37% |
| Cigna | Commercial | $953.25 | ↓ -35% |
| Occunet | Commercial | $1,145.85 | ↓ -22% |
| UPMC Health Plan | Commercial | $1,530.35 | ↑ +5% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,825.50 | ↑ +25% |
| Humana | Commercial | $1,947.20 | ↑ +33% |
| National Provider Network | PPO | $2,141.92 | ↑ +47% |
| UPMC Health Plan | CHIP | $2,482.82 | ↑ +70% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Njx interlaminar lmbr/sac at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,978.40 | $74.34 – $3,971.20 |
| UPMC Hamot | Erie | $3,178.80 | $81.77 – $1,234.49 |
| UPMC Horizon-Greenville | Greenville | $3,417.00 | $81.77 – $916.68 |
| UPMC Kane | Kane | $1,053.60 | $81.77 – $584.43 |
| UPMC Magee | Pittsburgh | $2,569.80 | $81.77 – $916.68 |
| UPMC Mercy | Pittsburgh | $2,406.00 | $81.77 – $933.66 |
| UPMC Passavant-McCandless | Pittsburgh | $3,717.60 | $81.77 – $933.66 |
| UPMC Presbyterian | Pittsburgh | $2,292.00 | $81.77 – $933.66 |