Tomosynthesis breast screen bilateral at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$45.00
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.
$75.00
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.
$16.48 with Highmark BCBS of PA vs $178.00 with United Healthcare — 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 | $16.48 | ↓ -63% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $23.06 | ↓ -49% |
| UPMC Health Plan | CHIP | $26.25 | ↓ -42% |
| UPMC Health Plan | Commercial | $33.75 | ↓ -25% |
| Highmark Wholecare (prev Gateway) | Medicare | $37.50 | ↓ -17% |
| Aetna of PA | Medicare | $46.18 | ↑ +3% |
| UPMC Health Plan | Managed Medicaid | $48.43 | ↑ +8% |
| Aetna | Medicaid | $49.75 | ↑ +11% |
| Cigna | Commercial | $56.08 | ↑ +25% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $56.25 | ↑ +25% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $57.24 | ↑ +27% |
| Humana | Commercial | $60.00 | ↑ +33% |
| Geisinger | Medicaid/CHIP | $61.20 | ↑ +36% |
| National Provider Network | PPO | $66.00 | ↑ +47% |
| UPMC Work Partners | Workers Comp | $74.61 | ↑ +66% |
| PA Health & Wellness | PA Medicaid HMO | $75.04 | ↑ +67% |
| United Healthcare | Commercial | $178.00 | ↑ +296% |
Visitor-reported prices
Comments
Tomosynthesis breast screen bilateral at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $45.00 | $16.19 – $60.00 |
| UPMC Bedford | Everett | $45.00 | $18.75 – $75.04 |
| UPMC Carlisle | Carlisle | $65.40 | $14.93 – $128.05 |
| UPMC Cole | Coudersport | $129.00 | $46.23 – $212.00 |
| UPMC Community Osteopathic | Harrisburg | $65.40 | $21.80 – $92.65 |
| UPMC Hamot | Erie | $45.00 | $16.19 – $75.04 |
| UPMC Northwest | Seneca | $45.00 | $42.02 – $75.04 |
| UPMC Hanover | Hanover | $65.40 | $26.27 – $128.05 |