Ghs simple repair 12.6 - 20.0 cm - 12005 at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$3,973.20
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.
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What you pay up front if you don't use insurance.
$6,622.00
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.
$101.20 with UPMC Health Plan vs $6,092.24 with Multiplan — 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 | $101.20 | ↓ -97% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $101.20 | ↓ -97% |
| Aetna | CHIP/Medicaid | $119.60 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $136.44 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $143.22 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $145.58 | ↓ -96% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $156.79 | ↓ -96% |
| UPMC Health Plan | Managed Medicare | $356.48 | ↓ -91% |
| UPMC Health Plan | Partners/Select | $390.73 | ↓ -90% |
| Aetna of PA | Medicare | $399.94 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $411.33 | ↓ -90% |
| United Healthcare | Medicare | $411.37 | ↓ -90% |
| AmeriHealth Caritas | Medicare | $411.37 | ↓ -90% |
| Aetna | Medicare | $418.99 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $424.29 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -81% |
| UPMC Health Plan | Commercial | $1,422.21 | ↓ -64% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,131.49 | ↓ -46% |
| UPMC Health Plan | CHIP | $2,297.06 | ↓ -42% |
| Aetna | Neighborhood Network | $2,383.92 | ↓ -40% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,471.31 | ↓ -38% |
| Aetna | EBR FI | $2,582.58 | ↓ -35% |
| Aetna | Home Depot Employer Group | $2,595.82 | ↓ -35% |
| Aetna | NBR ASO/FI | $2,648.80 | ↓ -33% |
| Aetna | EBR ASO | $2,648.80 | ↓ -33% |
| Cigna | New Business ASO | $2,648.80 | ↓ -33% |
| Cigna | Commercial | $2,648.80 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $2,854.47 | ↓ -28% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,309.63 | ↓ -17% |
| InterGroup | PPO | $3,311.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $4,281.72 | ↑ +8% |
| Coventry/First Health | Commercial | $4,635.40 | ↑ +17% |
| Preferred Healthcare System | PPO | $5,297.60 | ↑ +33% |
| Private Health Care Systems | PPO | $5,628.70 | ↑ +42% |
| Humana | Commercial | $5,628.70 | ↑ +42% |
| Multiplan | PPO | $6,092.24 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 12.6 - 20.0 cm - 12005 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,829.40 | $101.20 – $729.80 |
| UPMC Passavant-McCandless | Pittsburgh | $2,199.00 | $101.20 – $736.75 |
| UPMC Presbyterian | Pittsburgh | $4,765.20 | $101.20 – $931.20 |
| UPMC St. Margaret | Pittsburgh | $2,332.80 | $101.20 – $736.75 |
| UPMC Altoona | Altoona | $1,305.00 | $92.00 – $1,740.00 |
| UPMC Bedford | Everett | $1,626.60 | $96.60 – $2,439.90 |
| UPMC Carlisle | Carlisle | $819.60 | $116.84 – $1,161.10 |
| UPMC Cole | Coudersport | $1,693.20 | $96.60 – $1,041.88 |