Ghs simple repair 7.6 - 12.5 cm - 12004 at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$519.60
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.
$866.00
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.
$53.35 with UPMC Health Plan vs $1,199.61 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 | $53.35 | ↓ -90% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $53.35 | ↓ -90% |
| Aetna | CHIP/Medicaid | $63.05 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $71.93 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $75.50 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $76.75 | ↓ -85% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $82.65 | ↓ -84% |
| UPMC Health Plan | Managed Medicare | $177.30 | ↓ -66% |
| UPMC Health Plan | Partners/Select | $194.33 | ↓ -63% |
| Aetna of PA | Medicare | $198.91 | ↓ -62% |
| Highmark Wholecare (prev Gateway) | Medicare | $204.58 | ↓ -61% |
| United Healthcare | Medicare | $204.60 | ↓ -61% |
| AmeriHealth Caritas | Medicare | $204.60 | ↓ -61% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $206.41 | ↓ -60% |
| Aetna | Medicare | $208.38 | ↓ -60% |
| Aetna | Neighborhood Network | $311.76 | ↓ -40% |
| UPMC Work Partners | Workers Comp | $333.58 | ↓ -36% |
| Aetna | EBR FI | $337.74 | ↓ -35% |
| Aetna | Home Depot Employer Group | $339.47 | ↓ -35% |
| Aetna | EBR ASO | $346.40 | ↓ -33% |
| Cigna | New Business ASO | $346.40 | ↓ -33% |
| Cigna | Commercial | $346.40 | ↓ -33% |
| Aetna | NBR ASO/FI | $346.40 | ↓ -33% |
| UPMC Health Plan | Commercial | $393.56 | ↓ -24% |
| InterGroup | PPO | $433.00 | ↓ -17% |
| Highmark BCBS of PA | Managed Care - Social Mission | $597.18 | ↑ +15% |
| Coventry/First Health | Commercial | $606.20 | ↑ +17% |
| UPMC Health Plan | CHIP | $635.66 | ↑ +22% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $692.38 | ↑ +33% |
| Preferred Healthcare System | PPO | $692.80 | ↑ +33% |
| Private Health Care Systems | PPO | $736.10 | ↑ +42% |
| Humana | Commercial | $736.10 | ↑ +42% |
| Multiplan | PPO | $796.72 | ↑ +53% |
| Highmark BCBS of PA | Managed Care | $799.73 | ↑ +54% |
| Highmark BCBS of PA | Commercial - Indemnity | $927.26 | ↑ +78% |
| Highmark BCBS of PA | UPMC Emergent | $1,199.61 | ↑ +131% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 7.6 - 12.5 cm - 12004 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $510.00 | $53.35 – $268.39 |
| UPMC Passavant-McCandless | Pittsburgh | $1,070.40 | $53.35 – $387.88 |
| UPMC Presbyterian | Pittsburgh | $1,341.60 | $53.35 – $885.60 |
| UPMC St. Margaret | Pittsburgh | $753.00 | $53.35 – $333.58 |
| UPMC Altoona | Altoona | $819.60 | $48.50 – $1,092.80 |
| UPMC Bedford | Everett | $454.20 | $50.92 – $681.30 |
| UPMC Carlisle | Carlisle | $808.20 | $61.59 – $1,144.95 |
| UPMC Cole | Coudersport | $554.40 | $50.92 – $2,325.85 |