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Shoulder MRI (with contrast) at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$3,155.40
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.
$5,259.00
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.
$327.20 with Aetna of PA vs $4,365.68 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 |
|---|---|---|---|
| Aetna of PA | Medicare | $327.20 | ↓ -90% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $353.91 | ↓ -89% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $549.28 | ↓ -83% |
| Humana | Medicare | $753.23 | ↓ -76% |
| United Healthcare | Medicare | $753.23 | ↓ -76% |
| UPMC Health Plan | Managed Medicare | $785.02 | ↓ -75% |
| UPMC Health Plan | EPO Partners/Partners/Select | $786.52 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicare | $813.41 | ↓ -74% |
| AmeriHealth Caritas | Medicare | $813.49 | ↓ -74% |
| Cigna | Medicare | $813.49 | ↓ -74% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $813.49 | ↓ -74% |
| Occunet | Commercial | $941.54 | ↓ -70% |
| UPMC Health Plan | Commercial | $980.84 | ↓ -69% |
| UPMC Work Partners | Workers Comp | $1,109.81 | ↓ -65% |
| Cigna | Commercial | $1,122.38 | ↓ -64% |
| UPMC Health Plan | CHIP | $1,591.30 | ↓ -50% |
| United Healthcare | Commercial | $1,614.00 | ↓ -49% |
| Geisinger | Medicaid/CHIP | $2,728.55 | ↓ -14% |
| PA Health & Wellness | PA Medicaid HMO | $2,728.55 | ↓ -14% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $3,720.75 | ↑ +18% |
| Humana | Commercial | $3,968.80 | ↑ +26% |
| National Provider Network | PPO | $4,365.68 | ↑ +38% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder MRI (with contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,621.20 | $441.61 – $6,546.70 |
| UPMC East | Monroeville | $5,074.20 | $437.75 – $6,765.60 |
| UPMC Hamot | Erie | $1,948.80 | $201.09 – $2,273.60 |
| UPMC Horizon-Greenville | Greenville | $4,192.80 | $443.23 – $5,939.80 |
| UPMC Lititz | Lititz | $2,713.80 | $327.20 – $3,844.55 |
| UPMC McKeesport | Mckeesport | $4,936.20 | $449.34 – $6,992.95 |
| UPMC Altoona | Altoona | $2,119.20 | $425.00 – $2,825.60 |
| UPMC Carlisle | Carlisle | $2,713.80 | $403.15 – $3,844.55 |