Ercp bil/panc duct; each stent plcmt 43274 at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$3,596.40
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.
$5,994.00
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.
$156.59 with UPMC Health Plan vs $6,242.82 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 | Commercial | $156.59 | ↓ -96% |
| UPMC Health Plan | CHIP | $172.48 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $363.89 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $686.48 | ↓ -81% |
| Aetna | CHIP/Medicaid | $1,078.92 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,110.54 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,220.61 | ↓ -66% |
| Highmark BCBS of PA | Managed Care | $1,487.25 | ↓ -59% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,634.67 | ↓ -55% |
| Aetna | Neighborhood Network | $2,157.84 | ↓ -40% |
| Highmark BCBS of PA | UPMC Emergent | $2,230.88 | ↓ -38% |
| Aetna | EBR FI | $2,337.66 | ↓ -35% |
| Aetna | Home Depot Employer Group | $2,349.65 | ↓ -35% |
| Aetna | EBR ASO | $2,397.60 | ↓ -33% |
| Aetna | NBR ASO/FI | $2,397.60 | ↓ -33% |
| Cigna | Commercial | $2,397.60 | ↓ -33% |
| Cigna | New Business ASO | $2,397.60 | ↓ -33% |
| InterGroup | PPO | $2,997.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,296.70 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $3,296.70 | ↓ -8% |
| Coventry/First Health | Commercial | $4,195.80 | ↑ +17% |
| Preferred Healthcare System | PPO | $4,795.20 | ↑ +33% |
| Humana | Commercial | $5,094.90 | ↑ +42% |
| Private Health Care Systems | PPO | $5,094.90 | ↑ +42% |
| UPMC Health Plan | Managed Medicare | $5,311.50 | ↑ +48% |
| Multiplan | PPO | $5,514.48 | ↑ +53% |
| UPMC Health Plan | Partners/Select | $5,821.71 | ↑ +62% |
| Aetna of PA | Medicare | $5,959.05 | ↑ +66% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,128.75 | ↑ +70% |
| AmeriHealth Caritas | Medicare | $6,129.31 | ↑ +70% |
| United Healthcare | Medicare | $6,129.31 | ↑ +70% |
| Aetna | Medicare | $6,242.82 | ↑ +74% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ercp bil/panc duct; each stent plcmt 43274 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $4,282.20 | $95.34 – $6,242.82 |
| UPMC Passavant-McCandless | Pittsburgh | $2,919.00 | $96.12 – $6,242.82 |
| UPMC Presbyterian | Pittsburgh | $5,390.40 | $97.74 – $6,242.82 |
| UPMC St. Margaret | Pittsburgh | $4,000.80 | $99.65 – $6,242.82 |
| UPMC Altoona | Altoona | $3,517.80 | $172.48 – $6,129.31 |
| UPMC Cole | Coudersport | $858.60 | $172.48 – $1,144.80 |
| UPMC East | Monroeville | $3,055.20 | $98.53 – $6,129.31 |
| UPMC Hamot | Erie | $4,961.40 | $214.14 – $8,254.31 |