Vaccine pneumococcal conjugate 13 valent (pcv13) im at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$144.00
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.
$240.00
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.
$11.00 with UPMC Health Plan vs $1,033.30 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $11.00 | ↓ -92% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $11.50 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $13.00 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $13.90 | ↓ -90% |
| Cigna | Commercial | $73.92 | ↓ -49% |
| UPMC Work Partners | Workers Comp | $90.17 | ↓ -37% |
| United Healthcare | Commercial | $90.48 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $120.00 | ↓ -17% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $180.00 | ↑ +25% |
| Humana | Commercial | $192.00 | ↑ +33% |
| National Provider Network | PPO | $211.20 | ↑ +47% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $234.24 | ↑ +63% |
| PA Health & Wellness | PA Medicaid HMO | $257.99 | ↑ +79% |
| Aetna of PA | Medicare | $257.99 | ↑ +79% |
| UPMC Health Plan | CHIP | $299.36 | ↑ +108% |
| UPMC Health Plan | Commercial | $1,033.30 | ↑ +618% |
| Aetna | Medicaid | not published by hospital | — |
Visitor-reported prices
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Vaccine pneumococcal conjugate 13 valent (pcv13) im at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $144.00 | $10.00 – $773.97 |
| UPMC Bedford | Everett | $144.00 | $10.50 – $638.31 |
| UPMC East | Monroeville | $144.00 | $11.00 – $257.99 |
| UPMC Hamot | Erie | $144.00 | $11.00 – $702.37 |
| UPMC Northwest | Seneca | $144.00 | $11.00 – $597.39 |
| UPMC Horizon-Greenville | Greenville | $144.00 | $10.50 – $586.62 |
| UPMC Magee | Pittsburgh | $152.40 | $11.00 – $257.99 |
| UPMC McKeesport | Mckeesport | $144.00 | $11.00 – $283.79 |