Alys cplx sp/pn npgt w/prgrm at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$1,159.20
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.
$1,932.00
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.
$71.24 with UPMC Health Plan vs $1,777.44 with Multiplan — 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 | $71.24 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $71.24 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $81.90 | ↓ -93% |
| Aetna | CHIP/Medicaid | $84.19 | ↓ -93% |
| UPMC Health Plan | Partners/Select | $89.77 | ↓ -92% |
| Aetna of PA | Medicare | $91.89 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $94.50 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $94.51 | ↓ -92% |
| United Healthcare | Medicare | $94.51 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $96.04 | ↓ -92% |
| Aetna | Medicare | $96.26 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $100.81 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $102.48 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $110.36 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $148.04 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $192.30 | ↓ -83% |
| UPMC Health Plan | CHIP | $206.08 | ↓ -82% |
| UPMC Health Plan | Commercial | $318.36 | ↓ -73% |
| Highmark BCBS of PA | Managed Care - Social Mission | $586.88 | ↓ -49% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $645.05 | ↓ -44% |
| Aetna | Neighborhood Network | $695.52 | ↓ -40% |
| Aetna | EBR FI | $753.48 | ↓ -35% |
| Aetna | Home Depot Employer Group | $757.34 | ↓ -35% |
| Cigna | New Business ASO | $772.80 | ↓ -33% |
| Aetna | EBR ASO | $772.80 | ↓ -33% |
| Aetna | NBR ASO/FI | $772.80 | ↓ -33% |
| Cigna | Commercial | $772.80 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $785.96 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Indemnity | $863.87 | ↓ -25% |
| InterGroup | PPO | $966.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $1,178.94 | ↑ +2% |
| Coventry/First Health | Commercial | $1,352.40 | ↑ +17% |
| Preferred Healthcare System | PPO | $1,545.60 | ↑ +33% |
| Private Health Care Systems | PPO | $1,642.20 | ↑ +42% |
| Humana | Commercial | $1,642.20 | ↑ +42% |
| Multiplan | PPO | $1,777.44 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Alys cplx sp/pn npgt w/prgrm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,074.00 | $71.24 – $190.49 |
| UPMC Passavant-McCandless | Pittsburgh | $999.00 | $71.24 – $192.30 |
| UPMC Presbyterian | Pittsburgh | $1,378.20 | $71.24 – $192.30 |
| UPMC Carlisle | Carlisle | $369.60 | $82.25 – $523.60 |
| UPMC Cole | Coudersport | $151.20 | $42.23 – $201.60 |
| UPMC Community Osteopathic | Harrisburg | $369.60 | $82.25 – $523.60 |
| UPMC Hanover | Hanover | $369.60 | $82.25 – $154.93 |
| UPMC Lititz | Lititz | $369.60 | $82.25 – $154.93 |