Observation direct referral from physician office for admission at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$126.60
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.
$211.00
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.
$26.56 with UPMC Health Plan vs $5,089.42 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 |
|---|---|---|---|
| UPMC Health Plan | CHIP | $26.56 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $31.88 | ↓ -75% |
| Aetna | CHIP/Medicaid | $37.98 | ↓ -70% |
| Aetna | Neighborhood Network | $75.96 | ↓ -40% |
| Aetna | EBR FI | $82.29 | ↓ -35% |
| Aetna | Home Depot Employer Group | $82.71 | ↓ -35% |
| Aetna | NBR ASO/FI | $84.40 | ↓ -33% |
| Aetna | EBR ASO | $84.40 | ↓ -33% |
| Cigna | Commercial | $84.40 | ↓ -33% |
| Cigna | New Business ASO | $84.40 | ↓ -33% |
| InterGroup | PPO | $105.50 | ↓ -17% |
| Coventry/First Health | Commercial | $147.70 | ↑ +17% |
| Preferred Healthcare System | PPO | $168.80 | ↑ +33% |
| Private Health Care Systems | PPO | $179.35 | ↑ +42% |
| Humana | Commercial | $179.35 | ↑ +42% |
| Multiplan | PPO | $194.12 | ↑ +53% |
| UPMC Health Plan | Managed Medicare | $547.05 | ↑ +332% |
| Aetna of PA | Medicare | $613.75 | ↑ +385% |
| Highmark Wholecare (prev Gateway) | Medicare | $631.22 | ↑ +399% |
| United Healthcare | Medicare | $631.28 | ↑ +399% |
| AmeriHealth Caritas | Medicare | $631.28 | ↑ +399% |
| Aetna | Medicare | $642.97 | ↑ +408% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,137.42 | ↑ +1588% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $2,137.43 | ↑ +1588% |
| Geisinger | Medicaid/CHIP | $2,207.16 | ↑ +1643% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2,569.10 | ↑ +1929% |
| UPMC Health Plan | Partners/Select | $2,942.09 | ↑ +2224% |
| UPMC Health Plan | Commercial | $5,089.42 | ↑ +3920% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $85.20 | $26.56 – $642.97 |
| UPMC Passavant-McCandless | Pittsburgh | $138.00 | $31.88 – $642.97 |
| UPMC Presbyterian | Pittsburgh | $141.00 | $31.88 – $642.97 |
| UPMC St. Margaret | Pittsburgh | $133.20 | $31.88 – $642.97 |
| UPMC Altoona | Altoona | $117.00 | $27.00 – $2,064.00 |
| UPMC Bedford | Everett | $166.20 | $31.88 – $2,207.16 |
| UPMC Carlisle | Carlisle | $420.00 | $95.90 – $2,064.00 |
| UPMC Cole | Coudersport | $84.00 | $38.81 – $112.00 |