Tympanic membrane repair at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$6,809.40
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.
?
What you pay up front if you don't use insurance.
$11,349.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$91.30 with UPMC Health Plan vs $10,441.08 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $91.30 | ↓ -99% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $91.30 | ↓ -99% |
| Aetna | CHIP/Medicaid | $107.90 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $123.09 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $129.21 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $131.34 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $141.45 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $450.38 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $1,321.70 | ↓ -81% |
| UPMC Health Plan | Partners/Select | $1,448.66 | ↓ -79% |
| Aetna of PA | Medicare | $1,482.83 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,525.06 | ↓ -78% |
| AmeriHealth Caritas | Medicare | $1,525.20 | ↓ -78% |
| United Healthcare | Medicare | $1,525.20 | ↓ -78% |
| Aetna | Medicare | $1,553.44 | ↓ -77% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,646.97 | ↓ -76% |
| UPMC Health Plan | Commercial | $3,200.05 | ↓ -53% |
| Aetna | Neighborhood Network | $4,085.64 | ↓ -40% |
| Aetna | EBR FI | $4,426.11 | ↓ -35% |
| Aetna | Home Depot Employer Group | $4,448.81 | ↓ -35% |
| Cigna | New Business ASO | $4,539.60 | ↓ -33% |
| Aetna | EBR ASO | $4,539.60 | ↓ -33% |
| Aetna | NBR ASO/FI | $4,539.60 | ↓ -33% |
| Cigna | Commercial | $4,539.60 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,764.84 | ↓ -30% |
| UPMC Health Plan | CHIP | $5,168.52 | ↓ -24% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,524.47 | ↓ -19% |
| InterGroup | PPO | $5,674.50 | ↓ -17% |
| Highmark BCBS of PA | Managed Care | $6,381.00 | ↓ -6% |
| Highmark BCBS of PA | Commercial - Indemnity | $7,398.49 | ↑ +9% |
| Coventry/First Health | Commercial | $7,944.30 | ↑ +17% |
| Preferred Healthcare System | PPO | $9,079.20 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $9,571.54 | ↑ +41% |
| Humana | Commercial | $9,646.65 | ↑ +42% |
| Private Health Care Systems | PPO | $9,646.65 | ↑ +42% |
| Multiplan | PPO | $10,441.08 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Tympanic membrane repair at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $8,426.40 | $91.30 – $1,646.97 |
| UPMC Cole | Coudersport | $549.60 | $78.72 – $2,325.85 |
| Uniontown Hospital | Uniontown | $1,783.50 | $91.30 – $3,123.56 |
| UPMC Altoona | Altoona | not published | $83.00 – $1,631.43 |
| UPMC Bedford | Everett | not published | $87.15 – $1,525.20 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $10,638.00 – $10,638.00 |
| WellSpan Gettysburg Hospital | Gettysburg | not published | $970.00 – $1,101.92 |