Removal/replacement ppm generator dual lead system at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$13,717.80
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.
$22,863.00
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.
$455.84 with Highmark BCBS of PA vs $26,238.52 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $455.84 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $518.50 | ↓ -96% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $892.40 | ↓ -93% |
| Cigna | Commercial | $7,041.80 | ↓ -49% |
| Humana | Medicare | $9,977.44 | ↓ -27% |
| United Healthcare | Medicare | $9,977.44 | ↓ -27% |
| Aetna of PA | Medicare | $9,977.44 | ↓ -27% |
| UPMC Health Plan | Managed Medicare | $10,398.49 | ↓ -24% |
| UPMC Health Plan | EPO Partners/Partners/Select | $10,418.44 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicare | $10,774.64 | ↓ -21% |
| AmeriHealth Caritas | Medicare | $10,775.64 | ↓ -21% |
| Cigna | Medicare | $10,775.64 | ↓ -21% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,775.64 | ↓ -21% |
| United Healthcare | Commercial | $10,918.00 | ↓ -20% |
| Geisinger | Medicaid/CHIP | $12,574.65 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $12,574.65 | ↓ -8% |
| Occunet | Commercial | $13,469.54 | ↓ -2% |
| UPMC Health Plan | Commercial | $16,172.77 | ↑ +18% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $17,147.25 | ↑ +25% |
| Humana | Commercial | $18,290.40 | ↑ +33% |
| National Provider Network | PPO | $20,119.44 | ↑ +47% |
| UPMC Health Plan | CHIP | $26,238.52 | ↑ +91% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Removal/replacement ppm generator dual lead system at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,816.40 | $447.93 – $10,775.64 |
| UPMC Carlisle | Carlisle | $19,161.00 | $542.62 – $27,144.75 |
| UPMC Cole | Coudersport | $7,452.00 | $294.11 – $3,477.60 |
| UPMC Community Osteopathic | Harrisburg | $19,161.00 | $542.62 – $27,144.75 |
| UPMC East | Monroeville | $30,141.60 | $452.20 – $40,188.80 |
| UPMC Hamot | Erie | $9,586.80 | $447.93 – $14,511.47 |
| UPMC Hanover | Hanover | $19,161.00 | $542.62 – $26,238.52 |
| UPMC Lititz | Lititz | $19,161.00 | $379.69 – $26,238.52 |