Nasal/sinus endoscopy surg w/bx 31237 at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$3,451.80
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.
$5,753.00
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.
$470.27 with UPMC Work Partners vs $5,292.76 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 Work Partners | Workers Comp | $470.27 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -79% |
| Aetna | CHIP/Medicaid | $1,035.54 | ↓ -70% |
| UPMC Health Plan | Commercial | $1,423.84 | ↓ -59% |
| UPMC Health Plan | Managed Medicare | $1,538.69 | ↓ -55% |
| UPMC Health Plan | Partners/Select | $1,686.50 | ↓ -51% |
| Aetna of PA | Medicare | $1,726.28 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,775.44 | ↓ -49% |
| United Healthcare | Medicare | $1,775.61 | ↓ -49% |
| AmeriHealth Caritas | Medicare | $1,775.61 | ↓ -49% |
| Aetna | Medicare | $1,808.49 | ↓ -48% |
| Aetna | Neighborhood Network | $2,071.08 | ↓ -40% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,131.49 | ↓ -38% |
| Aetna | EBR FI | $2,243.67 | ↓ -35% |
| Aetna | Home Depot Employer Group | $2,255.18 | ↓ -35% |
| UPMC Health Plan | CHIP | $2,299.70 | ↓ -33% |
| Aetna | NBR ASO/FI | $2,301.20 | ↓ -33% |
| Cigna | New Business ASO | $2,301.20 | ↓ -33% |
| Cigna | Commercial | $2,301.20 | ↓ -33% |
| Aetna | EBR ASO | $2,301.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,471.31 | ↓ -28% |
| Highmark BCBS of PA | Managed Care | $2,854.47 | ↓ -17% |
| InterGroup | PPO | $2,876.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $3,164.15 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,164.15 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,309.63 | ↓ -4% |
| Coventry/First Health | Commercial | $4,027.10 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $4,281.72 | ↑ +24% |
| Preferred Healthcare System | PPO | $4,602.40 | ↑ +33% |
| Humana | Commercial | $4,890.05 | ↑ +42% |
| Private Health Care Systems | PPO | $4,890.05 | ↑ +42% |
| Multiplan | PPO | $5,292.76 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus endoscopy surg w/bx 31237 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $4,080.00 | $452.44 – $1,808.49 |
| UPMC Presbyterian | Pittsburgh | $5,543.40 | $452.44 – $1,808.49 |
| UPMC Cole | Coudersport | $385.80 | $55.16 – $1,041.88 |
| Uniontown Hospital | Uniontown | $2,374.00 | $205.80 – $3,583.20 |
| UPMC Altoona | Altoona | not published | $402.49 – $1,775.61 |
| UPMC Community Osteopathic | Harrisburg | not published | $469.07 – $5,805.45 |
| UPMC East | Monroeville | not published | $470.27 – $1,808.49 |
| UPMC Hamot | Erie | not published | $470.27 – $2,391.19 |