Ultrasound dx ophth b-scan at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$527.40
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.
?
What you pay up front if you don't use insurance.
$879.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$42.00 with United Healthcare Community Plan for Families vs $773.52 with National Provider Network — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $42.00 | ↓ -92% |
| United Healthcare | Medicare | $101.38 | ↓ -81% |
| Humana | Medicare | $101.38 | ↓ -81% |
| Aetna of PA | Medicare | $101.38 | ↓ -81% |
| UPMC Health Plan | Managed Medicare | $105.66 | ↓ -80% |
| UPMC Health Plan | EPO Partners/Partners/Select | $105.86 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $108.69 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -79% |
| Cigna | Medicare | $109.49 | ↓ -79% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -79% |
| Occunet | Commercial | $126.72 | ↓ -76% |
| UPMC Health Plan | Commercial | $212.35 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $223.16 | ↓ -58% |
| Cigna | Commercial | $251.90 | ↓ -52% |
| UPMC Health Plan | CHIP | $344.51 | ↓ -35% |
| United Healthcare | Commercial | $432.00 | ↓ -18% |
| Geisinger | Medicaid/CHIP | $483.45 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $483.45 | ↓ -8% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $659.25 | ↑ +25% |
| Humana | Commercial | $703.20 | ↑ +33% |
| National Provider Network | PPO | $773.52 | ↑ +47% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ultrasound dx ophth b-scan at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $552.00 | $101.65 – $736.00 |
| UPMC Hamot | Erie | $616.20 | $106.81 – $235.36 |
| UPMC Horizon-Greenville | Greenville | $514.80 | $90.77 – $223.16 |
| UPMC Magee | Pittsburgh | $468.00 | $94.88 – $235.36 |
| UPMC McKeesport | Mckeesport | $549.60 | $93.97 – $235.36 |
| UPMC Mercy | Pittsburgh | $438.00 | $84.51 – $236.43 |
| UPMC Passavant-McCandless | Pittsburgh | $600.60 | $94.21 – $273.67 |
| UPMC Presbyterian | Pittsburgh | $500.40 | $43.82 – $274.92 |