Dmd dup/delet analysis at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$3,223.20
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.
$5,372.00
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.
$169.79 with Highmark BCBS of PA vs $2,173.96 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 | $169.79 | ↓ -95% |
| UPMC Health Plan | Managed Medicare | $261.12 | ↓ -92% |
| Highmark BCBS of PA | Managed Care - Social Mission | $269.88 | ↓ -92% |
| UPMC Health Plan | Partners/Select | $286.20 | ↓ -91% |
| Aetna of PA | Medicare | $292.95 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $301.29 | ↓ -91% |
| United Healthcare | Medicare | $301.32 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $301.32 | ↓ -91% |
| Aetna | Medicare | $306.90 | ↓ -90% |
| Highmark BCBS of PA | Managed Care | $361.45 | ↓ -89% |
| Highmark BCBS of PA | UPMC Emergent | $542.17 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $569.52 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $577.50 | ↓ -82% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $577.50 | ↓ -82% |
| Aetna | CHIP/Medicaid | $682.50 | ↓ -79% |
| Highmark BCBS of PA | Commercial - Indemnity | $762.71 | ↓ -76% |
| Highmark Wholecare (prev Gateway) | Medicaid | $778.58 | ↓ -76% |
| Geisinger | Medicaid/CHIP | $817.27 | ↓ -75% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $830.76 | ↓ -74% |
| Aetna | Neighborhood Network | $850.68 | ↓ -74% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $894.71 | ↓ -72% |
| Aetna | EBR FI | $921.57 | ↓ -71% |
| Aetna | Home Depot Employer Group | $926.30 | ↓ -71% |
| Cigna | New Business ASO | $945.20 | ↓ -71% |
| Cigna | Commercial | $945.20 | ↓ -71% |
| Aetna | EBR ASO | $945.20 | ↓ -71% |
| Aetna | NBR ASO/FI | $945.20 | ↓ -71% |
| UPMC Health Plan | Commercial | $1,157.44 | ↓ -64% |
| InterGroup | PPO | $1,181.50 | ↓ -63% |
| Coventry/First Health | Commercial | $1,654.10 | ↓ -49% |
| Preferred Healthcare System | PPO | $1,890.40 | ↓ -41% |
| Private Health Care Systems | PPO | $2,008.55 | ↓ -38% |
| Humana | Commercial | $2,008.55 | ↓ -38% |
| UPMC Health Plan | CHIP | $2,116.18 | ↓ -34% |
| Multiplan | PPO | $2,173.96 | ↓ -33% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Dmd dup/delet analysis at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $402.60 | $169.79 – $817.27 |