Tc-99m exametazime diag at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$2,082.00
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.
$3,470.00
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.
$802.34 with Humana vs $3,270.62 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 |
|---|---|---|---|
| Humana | Medicare | $802.34 | ↓ -61% |
| Aetna of PA | Medicare | $802.34 | ↓ -61% |
| United Healthcare | Medicare | $802.34 | ↓ -61% |
| UPMC Health Plan | Managed Medicare | $836.20 | ↓ -60% |
| UPMC Health Plan | EPO Partners/Partners/Select | $837.80 | ↓ -60% |
| Highmark Wholecare (prev Gateway) | Medicare | $866.45 | ↓ -58% |
| AmeriHealth Caritas | Medicare | $866.53 | ↓ -58% |
| Cigna | Medicare | $866.53 | ↓ -58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $866.53 | ↓ -58% |
| Occunet | Commercial | $1,002.92 | ↓ -52% |
| Cigna | Commercial | $1,068.76 | ↓ -49% |
| United Healthcare | Commercial | $1,308.19 | ↓ -37% |
| UPMC Health Plan | Commercial | $1,561.50 | ↓ -25% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,684.72 | ↓ -19% |
| PA Health & Wellness | PA Medicaid HMO | $1,908.50 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $1,908.50 | ↓ -8% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $2,602.50 | ↑ +25% |
| Humana | Commercial | $2,776.00 | ↑ +33% |
| National Provider Network | PPO | $3,053.60 | ↑ +47% |
| UPMC Health Plan | CHIP | $3,270.62 | ↑ +57% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Tc-99m exametazime diag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $9,344.40 | $818.23 – $12,459.20 |
| UPMC Cole | Coudersport | $1,335.00 | $616.77 – $1,780.00 |
| UPMC East | Monroeville | $9,442.80 | $802.34 – $12,590.40 |
| UPMC Hamot | Erie | $3,633.00 | $802.34 – $1,655.50 |
| UPMC Northwest | Seneca | $1,750.20 | $727.64 – $866.53 |
| UPMC Horizon-Greenville | Greenville | $3,621.00 | $718.34 – $1,505.59 |
| UPMC Magee | Pittsburgh | $566.40 | $750.91 – $1,671.27 |
| UPMC McKeesport | Mckeesport | $4,600.20 | $743.69 – $1,671.27 |