Plmt biliary drainage cath at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$4,039.80
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.
$6,733.00
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.
$364.49 with UPMC Health Plan vs $6,483.32 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 | $364.49 | ↓ -91% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $364.49 | ↓ -91% |
| Aetna | CHIP/Medicaid | $430.75 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $491.39 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $515.81 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $524.33 | ↓ -87% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $564.69 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,115.58 | ↓ -72% |
| UPMC Work Partners | Workers Comp | $2,116.50 | ↓ -48% |
| UPMC Health Plan | CHIP | $2,356.55 | ↓ -42% |
| Aetna | Neighborhood Network | $2,423.88 | ↓ -40% |
| Aetna | EBR FI | $2,625.87 | ↓ -35% |
| Aetna | Home Depot Employer Group | $2,639.34 | ↓ -35% |
| Cigna | New Business ASO | $2,693.20 | ↓ -33% |
| Aetna | EBR ASO | $2,693.20 | ↓ -33% |
| Aetna | NBR ASO/FI | $2,693.20 | ↓ -33% |
| Cigna | Commercial | $2,693.20 | ↓ -33% |
| UPMC Health Plan | Commercial | $2,928.86 | ↓ -27% |
| UPMC Health Plan | Managed Medicare | $3,148.87 | ↓ -22% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,227.48 | ↓ -20% |
| InterGroup | PPO | $3,366.50 | ↓ -17% |
| UPMC Health Plan | Partners/Select | $3,451.35 | ↓ -15% |
| Aetna of PA | Medicare | $3,532.77 | ↓ -13% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,633.37 | ↓ -10% |
| AmeriHealth Caritas | Medicare | $3,633.70 | ↓ -10% |
| United Healthcare | Medicare | $3,633.70 | ↓ -10% |
| Aetna | Medicare | $3,700.99 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,742.02 | ↓ -7% |
| Highmark BCBS of PA | Managed Care | $4,322.19 | ↑ +7% |
| Coventry/First Health | Commercial | $4,713.10 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,011.40 | ↑ +24% |
| Preferred Healthcare System | PPO | $5,386.40 | ↑ +33% |
| Humana | Commercial | $5,723.05 | ↑ +42% |
| Private Health Care Systems | PPO | $5,723.05 | ↑ +42% |
| Multiplan | PPO | $6,194.36 | ↑ +53% |
| Highmark BCBS of PA | UPMC Emergent | $6,483.32 | ↑ +60% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Plmt biliary drainage cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $4,144.20 | $364.49 – $3,700.99 |
| UPMC Passavant-McCandless | Pittsburgh | $9,337.80 | $364.49 – $3,700.99 |
| UPMC Presbyterian | Pittsburgh | $6,424.80 | $364.49 – $3,700.99 |
| UPMC St. Margaret | Pittsburgh | $4,655.40 | $364.49 – $3,700.99 |
| UPMC Altoona | Altoona | $4,482.60 | $331.35 – $5,976.80 |
| UPMC Carlisle | Carlisle | $7,503.60 | $420.81 – $10,630.10 |
| UPMC Community Osteopathic | Harrisburg | $7,503.60 | $447.32 – $10,630.10 |
| UPMC East | Monroeville | $5,997.60 | $364.49 – $7,996.80 |