Exam plvc w/anes othr thn lcl at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$936.00
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.
$1,560.00
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.
$43.45 with UPMC Health Plan vs $4,281.72 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 | $43.45 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $43.45 | ↓ -95% |
| Aetna | CHIP/Medicaid | $51.35 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $58.58 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $61.49 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $62.50 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $67.32 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $88.00 | ↓ -91% |
| Aetna | Neighborhood Network | $561.60 | ↓ -40% |
| Aetna | EBR FI | $608.40 | ↓ -35% |
| Aetna | Home Depot Employer Group | $611.52 | ↓ -35% |
| Cigna | New Business ASO | $624.00 | ↓ -33% |
| Aetna | EBR ASO | $624.00 | ↓ -33% |
| Aetna | NBR ASO/FI | $624.00 | ↓ -33% |
| Cigna | Commercial | $624.00 | ↓ -33% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -21% |
| InterGroup | PPO | $780.00 | ↓ -17% |
| Coventry/First Health | Commercial | $1,092.00 | ↑ +17% |
| Preferred Healthcare System | PPO | $1,248.00 | ↑ +33% |
| Humana | Commercial | $1,326.00 | ↑ +42% |
| Private Health Care Systems | PPO | $1,326.00 | ↑ +42% |
| UPMC Health Plan | Commercial | $1,434.69 | ↑ +53% |
| Multiplan | PPO | $1,435.20 | ↑ +53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,131.49 | ↑ +128% |
| UPMC Health Plan | CHIP | $2,317.22 | ↑ +148% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,471.31 | ↑ +164% |
| UPMC Health Plan | Managed Medicare | $2,836.99 | ↑ +203% |
| Highmark BCBS of PA | Managed Care | $2,854.47 | ↑ +205% |
| UPMC Health Plan | Partners/Select | $3,109.51 | ↑ +232% |
| Aetna of PA | Medicare | $3,182.86 | ↑ +240% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,273.50 | ↑ +250% |
| United Healthcare | Medicare | $3,273.80 | ↑ +250% |
| AmeriHealth Caritas | Medicare | $3,273.80 | ↑ +250% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,309.63 | ↑ +254% |
| Aetna | Medicare | $3,334.43 | ↑ +256% |
| Highmark BCBS of PA | UPMC Emergent | $4,281.72 | ↑ +357% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exam plvc w/anes othr thn lcl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $200.40 | $41.48 – $1,041.88 |
| Uniontown Hospital | Uniontown | $465.00 | $43.45 – $6,516.82 |
| UPMC Altoona | Altoona | not published | $39.50 – $3,273.80 |
| UPMC Bedford | Everett | not published | $41.48 – $3,273.80 |
| UPMC Carlisle | Carlisle | not published | $50.16 – $4,866.56 |
| UPMC East | Monroeville | not published | $43.45 – $3,334.43 |
| UPMC Wellsboro | Wellsboro | not published | $43.45 – $128.00 |
| WellSpan Chambersburg Hospital | Chambersburg | not published | $970.00 – $14,622.99 |