Drainage of mouth lesion at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$2,577.60
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.
$4,296.00
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.
$25.85 with UPMC Health Plan vs $6,203.86 with Aetna — 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 | $25.85 | ↓ -99% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $25.85 | ↓ -99% |
| Aetna | CHIP/Medicaid | $30.55 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $34.85 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $36.58 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $37.19 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $40.05 | ↓ -98% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $550.23 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $595.54 | ↓ -77% |
| UPMC Health Plan | Commercial | $1,071.23 | ↓ -58% |
| Aetna | Neighborhood Network | $1,546.56 | ↓ -40% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,591.86 | ↓ -38% |
| Aetna | EBR FI | $1,675.44 | ↓ -35% |
| Aetna | Home Depot Employer Group | $1,684.03 | ↓ -35% |
| Aetna | EBR ASO | $1,718.40 | ↓ -33% |
| Cigna | New Business ASO | $1,718.40 | ↓ -33% |
| Aetna | NBR ASO/FI | $1,718.40 | ↓ -33% |
| Cigna | Commercial | $1,718.40 | ↓ -33% |
| UPMC Health Plan | CHIP | $1,730.18 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,845.64 | ↓ -28% |
| Highmark BCBS of PA | Managed Care | $2,131.80 | ↓ -17% |
| InterGroup | PPO | $2,148.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,471.73 | ↓ -4% |
| Coventry/First Health | Commercial | $3,007.20 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $3,197.71 | ↑ +24% |
| Preferred Healthcare System | PPO | $3,436.80 | ↑ +33% |
| Humana | Commercial | $3,651.60 | ↑ +42% |
| Private Health Care Systems | PPO | $3,651.60 | ↑ +42% |
| Multiplan | PPO | $3,952.32 | ↑ +53% |
| UPMC Health Plan | Managed Medicare | $5,278.35 | ↑ +105% |
| UPMC Health Plan | Partners/Select | $5,785.38 | ↑ +124% |
| Aetna of PA | Medicare | $5,921.86 | ↑ +130% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,090.50 | ↑ +136% |
| AmeriHealth Caritas | Medicare | $6,091.06 | ↑ +136% |
| United Healthcare | Medicare | $6,091.06 | ↑ +136% |
| Aetna | Medicare | $6,203.86 | ↑ +141% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Drainage of mouth lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,009.60 | $25.85 – $6,203.86 |
| UPMC Presbyterian | Pittsburgh | $4,468.20 | $25.85 – $6,203.86 |
| UPMC Cole | Coudersport | $612.00 | $24.68 – $816.00 |