healthcosts.net
Flexible Sigmoidoscopy at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$634.20
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.
?
What you pay up front if you don't use insurance.
$1,057.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$58.47 with UPMC Health Plan vs $1,962.99 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $58.47 | ↓ -91% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $58.47 | ↓ -91% |
| Aetna | CHIP/Medicaid | $69.09 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $78.82 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $82.74 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $84.10 | ↓ -87% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $90.58 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $208.89 | ↓ -67% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $337.77 | ↓ -47% |
| Aetna | Neighborhood Network | $380.52 | ↓ -40% |
| Aetna | EBR FI | $412.23 | ↓ -35% |
| Aetna | Home Depot Employer Group | $414.34 | ↓ -35% |
| Aetna | NBR ASO/FI | $422.80 | ↓ -33% |
| Cigna | New Business ASO | $422.80 | ↓ -33% |
| Cigna | Commercial | $422.80 | ↓ -33% |
| Aetna | EBR ASO | $422.80 | ↓ -33% |
| InterGroup | PPO | $528.50 | ↓ -17% |
| UPMC Health Plan | Commercial | $648.37 | ↑ +2% |
| Coventry/First Health | Commercial | $739.90 | ↑ +17% |
| UPMC Health Plan | Managed Medicare | $813.49 | ↑ +28% |
| Preferred Healthcare System | PPO | $845.60 | ↑ +33% |
| UPMC Health Plan | Partners/Select | $891.64 | ↑ +41% |
| Private Health Care Systems | PPO | $898.45 | ↑ +42% |
| Humana | Commercial | $898.45 | ↑ +42% |
| Aetna of PA | Medicare | $912.67 | ↑ +44% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↑ +48% |
| AmeriHealth Caritas | Medicare | $938.75 | ↑ +48% |
| United Healthcare | Medicare | $938.75 | ↑ +48% |
| Aetna | Medicare | $956.13 | ↑ +51% |
| Multiplan | PPO | $972.44 | ↑ +53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $977.20 | ↑ +54% |
| UPMC Health Plan | CHIP | $1,047.20 | ↑ +65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,132.99 | ↑ +79% |
| Highmark BCBS of PA | Managed Care | $1,308.65 | ↑ +106% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,517.33 | ↑ +139% |
| Highmark BCBS of PA | UPMC Emergent | $1,962.99 | ↑ +210% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Flexible Sigmoidoscopy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $598.20 | $58.47 – $956.13 |
| UPMC Mercy | Pittsburgh | $598.20 | $58.47 – $912.67 |
| UPMC Presbyterian | Pittsburgh | $748.80 | $58.47 – $1,060.80 |
| UPMC St. Margaret | Pittsburgh | $598.20 | $58.47 – $912.67 |
| UPMC East | Monroeville | $598.20 | $58.47 – $912.67 |
| UPMC Hamot | Erie | $598.20 | $58.47 – $1,264.19 |
| UPMC Carlisle | Carlisle | $1,158.00 | $67.50 – $1,640.50 |
| UPMC Altoona | Altoona | $598.20 | $53.15 – $797.60 |