Unlisted procedure microbiology at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$128.40
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.
$214.00
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.
$5.06 with United Healthcare vs $253.62 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 |
|---|---|---|---|
| United Healthcare | Commercial | $5.06 | ↓ -96% |
| Cigna | Commercial | $59.68 | ↓ -54% |
| Aetna of PA | Medicare | $64.20 | ↓ -50% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $93.79 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $107.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $117.70 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $117.70 | ↓ -8% |
| UPMC Health Plan | Commercial | $156.33 | ↑ +22% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $160.50 | ↑ +25% |
| Humana | Commercial | $171.20 | ↑ +33% |
| National Provider Network | PPO | $188.32 | ↑ +47% |
| UPMC Health Plan | CHIP | $253.62 | ↑ +98% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Unlisted procedure microbiology at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $124.80 | $92.16 – $253.62 |
| UPMC Bedford | Everett | $578.40 | $70.73 – $867.60 |
| UPMC Carlisle | Carlisle | $112.20 | $25.62 – $308.94 |
| UPMC Community Osteopathic | Harrisburg | $112.20 | $37.40 – $368.42 |
| UPMC East | Monroeville | $711.60 | $69.77 – $948.80 |
| UPMC Hamot | Erie | $193.20 | $29.65 – $126.65 |
| UPMC Northwest | Seneca | $312.00 | $70.42 – $239.19 |
| UPMC Hanover | Hanover | $112.20 | $91.96 – $308.94 |