Kit lead specify 5-6-5 at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$12,075.00
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.
$20,125.00
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.
$36.00 with Aetna vs $20,346.95 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $36.00 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicaid | $46.00 | ↓ -100% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $66.00 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $66.00 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $67.66 | ↓ -99% |
| Aetna | Neighborhood Network | $72.00 | ↓ -99% |
| Aetna | EBR FI | $78.00 | ↓ -99% |
| Aetna | Home Depot Employer Group | $78.40 | ↓ -99% |
| Cigna | New Business ASO | $80.00 | ↓ -99% |
| Aetna | NBR ASO/FI | $80.00 | ↓ -99% |
| Cigna | Commercial | $80.00 | ↓ -99% |
| Aetna | EBR ASO | $80.00 | ↓ -99% |
| InterGroup | PPO | $100.00 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $100.00 | ↓ -99% |
| Coventry/First Health | Commercial | $140.00 | ↓ -99% |
| Preferred Healthcare System | PPO | $160.00 | ↓ -99% |
| Private Health Care Systems | PPO | $170.00 | ↓ -99% |
| Humana | Commercial | $170.00 | ↓ -99% |
| Multiplan | PPO | $184.00 | ↓ -98% |
| Aetna | Medicare | $640.86 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $2,174.09 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7,292.63 | ↓ -40% |
| Highmark BCBS of PA | Managed Care - Social Mission | $7,394.82 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Indemnity | $9,766.45 | ↓ -19% |
| Highmark BCBS of PA | Managed Care | $9,903.74 | ↓ -18% |
| UPMC Health Plan | CHIP | $13,170.92 | ↑ +9% |
| Highmark BCBS of PA | UPMC Emergent | $14,855.67 | ↑ +23% |
| UPMC Health Plan | Commercial | $20,346.95 | ↑ +69% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Kit lead specify 5-6-5 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $41,212.80 | $2,153.59 – $10,400.32 |
| UPMC Passavant-McCandless | Pittsburgh | $17,425.20 | $2,174.09 – $19,112.65 |
| UPMC Presbyterian | Pittsburgh | $54,950.40 | $2,174.09 – $21,295.03 |
| UPMC St. Margaret | Pittsburgh | $6,860.40 | $2,174.09 – $16,161.66 |
| UPMC Altoona | Altoona | $25,039.80 | $37.62 – $13,170.92 |
| UPMC Bedford | Everett | $7,272.00 | $38.00 – $13,170.92 |
| UPMC Cole | Coudersport | $18,036.00 | $5,711.40 – $24,048.00 |
| UPMC East | Monroeville | $21,221.40 | $133.00 – $13,170.92 |