X-ray surgical specimen at UPMC Jameson
1211 Wilmington Avenue, New Castle, PA · UPMC · · NPI 111471575
$551.40
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.
$919.00
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.
$12.21 with United Healthcare Community Plan for Families vs $1,264.03 with Cigna — 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 | $12.21 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $20.58 | ↓ -96% |
| Aetna | Medicaid | $21.14 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $24.32 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $26.01 | ↓ -95% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $28.45 | ↓ -95% |
| PA Health & Wellness | PA Medicaid HMO | $31.89 | ↓ -94% |
| Aetna of PA | Medicare | $35.53 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $56.73 | ↓ -90% |
| UPMC Health Plan | Commercial | $58.89 | ↓ -89% |
| UPMC Health Plan | CHIP | $95.54 | ↓ -83% |
| United Healthcare | Commercial | $313.00 | ↓ -43% |
| Highmark Wholecare (prev Gateway) | Medicare | $459.50 | ↓ -17% |
| Humana | Medicare | $522.74 | ↓ -5% |
| United Healthcare | Medicare | $522.74 | ↓ -5% |
| UPMC Health Plan | Managed Medicare | $544.80 | ↓ -1% |
| UPMC Health Plan | EPO Partners/Partners/Select | $545.85 | ↓ -1% |
| Cigna | Medicare | $564.56 | ↑ +2% |
| AmeriHealth Caritas | Medicare | $564.56 | ↑ +2% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $564.56 | ↑ +2% |
| Occunet | Commercial | $653.42 | ↑ +19% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $689.25 | ↑ +25% |
| Humana | Commercial | $735.20 | ↑ +33% |
| National Provider Network | PPO | $808.72 | ↑ +47% |
| Cigna | Commercial | $1,264.03 | ↑ +129% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
X-ray surgical specimen at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $190.20 | $10.62 – $253.60 |
| UPMC Bedford | Everett | $540.60 | $19.65 – $810.90 |
| UPMC Carlisle | Carlisle | $1,129.80 | $13.91 – $1,600.55 |
| UPMC Cole | Coudersport | $80.40 | $19.65 – $107.20 |
| UPMC Community Osteopathic | Harrisburg | $1,129.80 | $13.91 – $1,600.55 |
| UPMC East | Monroeville | $4,123.80 | $20.58 – $5,498.40 |
| UPMC Hamot | Erie | $562.20 | $20.58 – $714.96 |
| UPMC Northwest | Seneca | $536.40 | $20.58 – $548.88 |