Biliary endoscopy thru skin at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$12,186.60
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.
$20,311.00
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.
$247.50 with United Healthcare Community Plan for Families vs $18,686.12 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $247.50 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $247.50 | ↓ -98% |
| Aetna | CHIP/Medicaid | $292.50 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $333.68 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $350.26 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $356.04 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $383.44 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $1,026.00 | ↓ -92% |
| UPMC Health Plan | Commercial | $1,087.83 | ↓ -91% |
| UPMC Health Plan | CHIP | $1,757.00 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $2,379.50 | ↓ -80% |
| Highmark BCBS of PA | Managed Care - Social Mission | $7,261.87 | ↓ -40% |
| Aetna | Neighborhood Network | $7,311.96 | ↓ -40% |
| Aetna | EBR FI | $7,921.29 | ↓ -35% |
| Aetna | Home Depot Employer Group | $7,961.91 | ↓ -35% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7,981.61 | ↓ -35% |
| Aetna | EBR ASO | $8,124.40 | ↓ -33% |
| Cigna | New Business ASO | $8,124.40 | ↓ -33% |
| Cigna | Commercial | $8,124.40 | ↓ -33% |
| Aetna | NBR ASO/FI | $8,124.40 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $9,289.60 | ↓ -24% |
| Highmark BCBS of PA | Managed Care | $9,725.18 | ↓ -20% |
| InterGroup | PPO | $10,155.50 | ↓ -17% |
| UPMC Health Plan | Partners/Select | $10,181.94 | ↓ -16% |
| Aetna of PA | Medicare | $10,422.14 | ↓ -14% |
| Highmark BCBS of PA | Commercial - Indemnity | $10,689.15 | ↓ -12% |
| Highmark Wholecare (prev Gateway) | Medicare | $10,718.93 | ↓ -12% |
| AmeriHealth Caritas | Medicare | $10,719.92 | ↓ -12% |
| United Healthcare | Medicare | $10,719.92 | ↓ -12% |
| Aetna | Medicare | $10,918.43 | ↓ -10% |
| Coventry/First Health | Commercial | $14,217.70 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $14,587.77 | ↑ +20% |
| Preferred Healthcare System | PPO | $16,248.80 | ↑ +33% |
| Humana | Commercial | $17,264.35 | ↑ +42% |
| Private Health Care Systems | PPO | $17,264.35 | ↑ +42% |
| Multiplan | PPO | $18,686.12 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $18,827.40 | $285.75 – $26,672.15 |
| UPMC Community Osteopathic | Harrisburg | $18,827.40 | $294.75 – $26,672.15 |
| UPMC Hamot | Erie | $5,424.00 | $247.50 – $12,372.12 |
| UPMC Hanover | Hanover | $18,827.40 | $285.75 – $15,913.34 |
| UPMC Lititz | Lititz | $18,827.40 | $285.75 – $15,999.30 |
| UPMC Memorial | York | $18,827.40 | $285.75 – $15,973.31 |
| UPMC Somerset | Somerset | $18,827.40 | $247.50 – $9,925.85 |
| UPMC Williamsport | Williamsport | $1,036.20 | $247.50 – $10,620.66 |