Anoscopy and biopsy at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$9,897.00
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.
$16,495.00
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.
$22.00 with UPMC Health Plan vs $15,175.40 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 | $22.00 | ↓ -100% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $22.00 | ↓ -100% |
| Aetna | CHIP/Medicaid | $26.00 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.66 | ↓ -100% |
| Geisinger | Medicaid/CHIP | $31.13 | ↓ -100% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.65 | ↓ -100% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $34.08 | ↓ -100% |
| UPMC Work Partners | Workers Comp | $98.87 | ↓ -99% |
| UPMC Health Plan | Managed Medicare | $1,052.05 | ↓ -89% |
| UPMC Health Plan | Partners/Select | $1,153.11 | ↓ -88% |
| Aetna of PA | Medicare | $1,180.32 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,213.93 | ↓ -88% |
| United Healthcare | Medicare | $1,214.04 | ↓ -88% |
| AmeriHealth Caritas | Medicare | $1,214.04 | ↓ -88% |
| Aetna | Medicare | $1,236.52 | ↓ -88% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,361.59 | ↓ -86% |
| UPMC Health Plan | Commercial | $2,646.69 | ↓ -73% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,939.21 | ↓ -60% |
| UPMC Health Plan | CHIP | $4,274.76 | ↓ -57% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,567.22 | ↓ -54% |
| Highmark BCBS of PA | Managed Care | $5,275.33 | ↓ -47% |
| Aetna | Neighborhood Network | $5,938.20 | ↓ -40% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,116.52 | ↓ -38% |
| Aetna | EBR FI | $6,433.05 | ↓ -35% |
| Aetna | Home Depot Employer Group | $6,466.04 | ↓ -35% |
| Cigna | New Business ASO | $6,598.00 | ↓ -33% |
| Aetna | EBR ASO | $6,598.00 | ↓ -33% |
| Aetna | NBR ASO/FI | $6,598.00 | ↓ -33% |
| Cigna | Commercial | $6,598.00 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $7,913.03 | ↓ -20% |
| InterGroup | PPO | $8,247.50 | ↓ -17% |
| Coventry/First Health | Commercial | $11,546.50 | ↑ +17% |
| Preferred Healthcare System | PPO | $13,196.00 | ↑ +33% |
| Humana | Commercial | $14,020.75 | ↑ +42% |
| Private Health Care Systems | PPO | $14,020.75 | ↑ +42% |
| Multiplan | PPO | $15,175.40 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Anoscopy and biopsy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,726.60 | $22.00 – $1,361.59 |
| UPMC Presbyterian | Pittsburgh | $8,398.20 | $22.00 – $1,361.59 |
| UPMC Cole | Coudersport | $130.20 | $21.00 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | not published | $27.00 – $4,274.76 |
| UPMC Hamot | Erie | not published | $22.00 – $1,634.95 |
| UPMC Memorial | York | not published | $25.40 – $1,808.99 |
| WellSpan Chambersburg Hospital | Chambersburg | not published | $970.00 – $5,422.70 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $1,150.15 – $5,627.00 |