Close lac/mouth vest/2.5 cm or < 40830 at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$543.00
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.
?
What you pay up front if you don't use insurance.
$905.00
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.
$34.65 with United Healthcare Community Plan for Families vs $832.60 with Multiplan — 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 | $34.65 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $34.65 | ↓ -94% |
| Aetna | CHIP/Medicaid | $40.95 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $46.71 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $49.04 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $49.85 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $53.68 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $131.35 | ↓ -76% |
| UPMC Health Plan | Managed Medicare | $207.20 | ↓ -62% |
| UPMC Work Partners | Workers Comp | $210.45 | ↓ -61% |
| UPMC Health Plan | Partners/Select | $227.10 | ↓ -58% |
| Aetna of PA | Medicare | $232.46 | ↓ -57% |
| Highmark Wholecare (prev Gateway) | Medicare | $239.08 | ↓ -56% |
| United Healthcare | Medicare | $239.10 | ↓ -56% |
| AmeriHealth Caritas | Medicare | $239.10 | ↓ -56% |
| Aetna | Medicare | $243.53 | ↓ -55% |
| UPMC Health Plan | Commercial | $248.77 | ↓ -54% |
| Aetna | Neighborhood Network | $325.80 | ↓ -40% |
| Aetna | EBR FI | $352.95 | ↓ -35% |
| Aetna | Home Depot Employer Group | $354.76 | ↓ -35% |
| Cigna | New Business ASO | $362.00 | ↓ -33% |
| Cigna | Commercial | $362.00 | ↓ -33% |
| Aetna | EBR ASO | $362.00 | ↓ -33% |
| Aetna | NBR ASO/FI | $362.00 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $380.02 | ↓ -30% |
| UPMC Health Plan | CHIP | $401.80 | ↓ -26% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $440.61 | ↓ -19% |
| InterGroup | PPO | $452.50 | ↓ -17% |
| Highmark BCBS of PA | Managed Care | $508.92 | ↓ -6% |
| Highmark BCBS of PA | Commercial - Indemnity | $590.07 | ↑ +9% |
| Coventry/First Health | Commercial | $633.50 | ↑ +17% |
| Preferred Healthcare System | PPO | $724.00 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $763.38 | ↑ +41% |
| Humana | Commercial | $769.25 | ↑ +42% |
| Private Health Care Systems | PPO | $769.25 | ↑ +42% |
| Multiplan | PPO | $832.60 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Close lac/mouth vest/2.5 cm or < 40830 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $882.60 | $34.65 – $243.53 |
| UPMC Passavant-McCandless | Pittsburgh | $1,373.40 | $34.65 – $244.71 |
| UPMC Presbyterian | Pittsburgh | $2,009.40 | $34.65 – $591.60 |
| UPMC St. Margaret | Pittsburgh | $453.00 | $34.65 – $243.53 |
| UPMC Altoona | Altoona | $530.40 | $31.50 – $707.20 |
| UPMC Bedford | Everett | $898.20 | $33.08 – $1,347.30 |
| UPMC Carlisle | Carlisle | $777.60 | $40.01 – $1,101.60 |
| UPMC Community Osteopathic | Harrisburg | $777.60 | $40.01 – $1,101.60 |