Drainage of nose lesion int 30000 at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$3,480.00
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.
$5,800.00
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.
$56.10 with UPMC Health Plan vs $9,571.54 with Highmark BCBS of PA — 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 | $56.10 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $56.10 | ↓ -98% |
| Aetna | CHIP/Medicaid | $66.30 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $75.63 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $79.39 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $80.70 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $86.91 | ↓ -98% |
| UPMC Health Plan | Managed Medicare | $207.20 | ↓ -94% |
| UPMC Health Plan | Partners/Select | $227.10 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $231.21 | ↓ -93% |
| Aetna of PA | Medicare | $232.46 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $239.08 | ↓ -93% |
| United Healthcare | Medicare | $239.10 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $239.10 | ↓ -93% |
| Aetna | Medicare | $243.53 | ↓ -93% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,646.97 | ↓ -53% |
| Aetna | Neighborhood Network | $2,088.00 | ↓ -40% |
| Aetna | EBR FI | $2,262.00 | ↓ -35% |
| Aetna | Home Depot Employer Group | $2,273.60 | ↓ -35% |
| Cigna | New Business ASO | $2,320.00 | ↓ -33% |
| Aetna | EBR ASO | $2,320.00 | ↓ -33% |
| Aetna | NBR ASO/FI | $2,320.00 | ↓ -33% |
| Cigna | Commercial | $2,320.00 | ↓ -33% |
| InterGroup | PPO | $2,900.00 | ↓ -17% |
| UPMC Health Plan | Commercial | $3,189.44 | ↓ -8% |
| Coventry/First Health | Commercial | $4,060.00 | ↑ +17% |
| Preferred Healthcare System | PPO | $4,640.00 | ↑ +33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,764.84 | ↑ +37% |
| Humana | Commercial | $4,930.00 | ↑ +42% |
| Private Health Care Systems | PPO | $4,930.00 | ↑ +42% |
| UPMC Health Plan | CHIP | $5,151.38 | ↑ +48% |
| Multiplan | PPO | $5,336.00 | ↑ +53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,524.47 | ↑ +59% |
| Highmark BCBS of PA | Managed Care | $6,381.00 | ↑ +83% |
| Highmark BCBS of PA | Commercial - Indemnity | $7,398.49 | ↑ +113% |
| Highmark BCBS of PA | UPMC Emergent | $9,571.54 | ↑ +175% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Drainage of nose lesion int 30000 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,688.80 | $56.10 – $1,631.43 |
| UPMC Passavant-McCandless | Pittsburgh | $3,688.80 | $56.10 – $1,646.97 |
| UPMC Presbyterian | Pittsburgh | $4,920.00 | $56.10 – $1,646.97 |
| UPMC Altoona | Altoona | $3,421.20 | $51.00 – $4,561.60 |
| UPMC Carlisle | Carlisle | $649.80 | $64.77 – $1,016.56 |
| UPMC Community Osteopathic | Harrisburg | $649.80 | $64.77 – $5,151.38 |
| UPMC Hanover | Hanover | $649.80 | $64.77 – $1,016.56 |
| UPMC Lititz | Lititz | $649.80 | $64.77 – $1,016.56 |