healthcosts.net
Annual Physical, Established Patient (age 40-64) at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$590.40
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.
$984.00
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.
$29.59 with Highmark BCBS of PA vs $905.28 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $29.59 | ↓ -95% |
| Aetna of PA | Medicare | $36.08 | ↓ -94% |
| UPMC Health Plan | Commercial | $92.42 | ↓ -84% |
| UPMC Health Plan | CHIP | $96.71 | ↓ -84% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $99.26 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $100.65 | ↓ -83% |
| Aetna | Medicare | $122.39 | ↓ -79% |
| Highmark BCBS of PA | Commercial - Indemnity | $132.93 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $134.80 | ↓ -77% |
| Highmark BCBS of PA | UPMC Emergent | $202.21 | ↓ -66% |
| UPMC Health Plan | Managed Medicaid | $243.10 | ↓ -59% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $243.10 | ↓ -59% |
| Aetna | CHIP/Medicaid | $287.30 | ↓ -51% |
| Highmark Wholecare (prev Gateway) | Medicaid | $327.74 | ↓ -44% |
| Geisinger | Medicaid/CHIP | $344.03 | ↓ -42% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $349.71 | ↓ -41% |
| Aetna | Neighborhood Network | $354.24 | ↓ -40% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $376.63 | ↓ -36% |
| Aetna | EBR FI | $383.76 | ↓ -35% |
| Aetna | Home Depot Employer Group | $385.73 | ↓ -35% |
| Aetna | EBR ASO | $393.60 | ↓ -33% |
| Aetna | NBR ASO/FI | $393.60 | ↓ -33% |
| Cigna | Commercial | $393.60 | ↓ -33% |
| Cigna | New Business ASO | $393.60 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $492.00 | ↓ -17% |
| InterGroup | PPO | $492.00 | ↓ -17% |
| Coventry/First Health | Commercial | $688.80 | ↑ +17% |
| Preferred Healthcare System | PPO | $787.20 | ↑ +33% |
| Humana | Commercial | $836.40 | ↑ +42% |
| Private Health Care Systems | PPO | $836.40 | ↑ +42% |
| Multiplan | PPO | $905.28 | ↑ +53% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Annual Physical, Established Patient (age 40-64) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $154.80 | $29.31 – $206.40 |
| UPMC Community Osteopathic | Harrisburg | $148.20 | $26.20 – $209.95 |
| UPMC Somerset | Somerset | $148.20 | $23.00 – $185.25 |
| UPMC Wellsboro | Wellsboro | $170.40 | $25.60 – $255.60 |
| UPMC Williamsport | Williamsport | $96.60 | $25.60 – $144.90 |