Surgical pathology level 4 gross & microscopic examination at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$98.40
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.
$164.00
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.
$10.35 with United Healthcare Community Plan for Families vs $158.79 with UPMC Work Partners — 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 | $10.35 | ↓ -89% |
| United Healthcare | Commercial | $27.10 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $33.69 | ↓ -66% |
| UPMC Health Plan | Managed Medicaid | $37.40 | ↓ -62% |
| Aetna | Medicaid | $38.42 | ↓ -61% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $38.43 | ↓ -61% |
| Geisinger | Medicaid/CHIP | $47.26 | ↓ -52% |
| Occunet | Commercial | $50.94 | ↓ -48% |
| Aetna of PA | Medicare | $50.94 | ↓ -48% |
| Humana | Medicare | $50.94 | ↓ -48% |
| United Healthcare | Medicare | $50.94 | ↓ -48% |
| UPMC Health Plan | Managed Medicare | $53.09 | ↓ -46% |
| UPMC Health Plan | EPO Partners/Partners/Select | $53.19 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicare | $55.01 | ↓ -44% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $55.02 | ↓ -44% |
| Cigna | Medicare | $55.02 | ↓ -44% |
| AmeriHealth Caritas | Medicare | $55.02 | ↓ -44% |
| PA Health & Wellness | PA Medicaid HMO | $57.94 | ↓ -41% |
| UPMC Health Plan | Commercial | $61.72 | ↓ -37% |
| Cigna | Commercial | $90.97 | ↓ -8% |
| UPMC Health Plan | CHIP | $100.13 | ↑ +2% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $123.00 | ↑ +25% |
| Humana | Commercial | $131.20 | ↑ +33% |
| National Provider Network | PPO | $144.32 | ↑ +47% |
| UPMC Work Partners | Workers Comp | $158.79 | ↑ +61% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 4 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $197.40 | $9.00 – $263.20 |
| UPMC Bedford | Everett | $100.20 | $18.38 – $156.82 |
| UPMC Carlisle | Carlisle | $116.40 | $11.79 – $164.12 |
| UPMC Cole | Coudersport | $169.20 | $35.70 – $225.60 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $11.79 – $166.18 |
| UPMC East | Monroeville | $255.60 | $27.54 – $340.80 |
| UPMC Hamot | Erie | $250.20 | $33.11 – $168.74 |
| UPMC Northwest | Seneca | $169.20 | $27.80 – $158.79 |