Colonoscopy submucous njx at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$3,471.00
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.
$5,785.00
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.
$154.22 with UPMC Health Plan vs $5,322.20 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 | Commercial | $154.22 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $234.53 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $234.53 | ↓ -93% |
| UPMC Health Plan | CHIP | $249.09 | ↓ -93% |
| Aetna | CHIP/Medicaid | $277.17 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $316.19 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $331.90 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $337.38 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $363.35 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $715.89 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $792.58 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $1,052.05 | ↓ -70% |
| UPMC Health Plan | Partners/Select | $1,153.11 | ↓ -67% |
| Aetna of PA | Medicare | $1,180.32 | ↓ -66% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,213.93 | ↓ -65% |
| AmeriHealth Caritas | Medicare | $1,214.04 | ↓ -65% |
| United Healthcare | Medicare | $1,214.04 | ↓ -65% |
| Aetna | Medicare | $1,236.52 | ↓ -64% |
| Aetna | Neighborhood Network | $2,082.60 | ↓ -40% |
| Aetna | EBR FI | $2,256.15 | ↓ -35% |
| Aetna | Home Depot Employer Group | $2,267.72 | ↓ -35% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,293.00 | ↓ -34% |
| Cigna | Commercial | $2,314.00 | ↓ -33% |
| Aetna | NBR ASO/FI | $2,314.00 | ↓ -33% |
| Aetna | EBR ASO | $2,314.00 | ↓ -33% |
| Cigna | New Business ASO | $2,314.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,658.57 | ↓ -23% |
| InterGroup | PPO | $2,892.50 | ↓ -17% |
| Highmark BCBS of PA | Managed Care | $3,070.76 | ↓ -12% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,560.41 | ↑ +3% |
| Coventry/First Health | Commercial | $4,049.50 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $4,606.16 | ↑ +33% |
| Preferred Healthcare System | PPO | $4,628.00 | ↑ +33% |
| Humana | Commercial | $4,917.25 | ↑ +42% |
| Private Health Care Systems | PPO | $4,917.25 | ↑ +42% |
| Multiplan | PPO | $5,322.20 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy submucous njx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,528.00 | $156.49 – $1,236.52 |
| UPMC Passavant-McCandless | Pittsburgh | $4,137.60 | $112.59 – $1,236.52 |
| UPMC Presbyterian | Pittsburgh | $4,659.00 | $94.76 – $1,236.52 |
| UPMC St. Margaret | Pittsburgh | $3,903.60 | $111.79 – $1,236.52 |
| UPMC Altoona | Altoona | $1,764.60 | $213.21 – $2,352.80 |
| UPMC Bedford | Everett | $5,152.80 | $137.39 – $7,729.20 |
| UPMC Cole | Coudersport | $687.00 | $223.87 – $1,041.88 |
| UPMC East | Monroeville | $3,903.60 | $234.53 – $5,204.80 |