Unlisted procedure rectum at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$554.40
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.
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What you pay up front if you don't use insurance.
$924.00
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.
$18.77 with Highmark BCBS of PA vs $956.13 with Aetna — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | ↓ -97% |
| Highmark BCBS of PA | Managed Care - Social Mission | $54.29 | ↓ -90% |
| UPMC Health Plan | Commercial | $59.69 | ↓ -89% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $62.94 | ↓ -89% |
| UPMC Health Plan | CHIP | $65.74 | ↓ -88% |
| Highmark BCBS of PA | Managed Care | $72.70 | ↓ -87% |
| Highmark BCBS of PA | Commercial - Indemnity | $84.30 | ↓ -85% |
| Highmark BCBS of PA | UPMC Emergent | $109.06 | ↓ -80% |
| Aetna | CHIP/Medicaid | $148.14 | ↓ -73% |
| Aetna | Neighborhood Network | $296.28 | ↓ -47% |
| Aetna | EBR FI | $320.97 | ↓ -42% |
| Aetna | Home Depot Employer Group | $322.62 | ↓ -42% |
| Cigna | New Business ASO | $329.20 | ↓ -41% |
| Aetna | EBR ASO | $329.20 | ↓ -41% |
| Aetna | NBR ASO/FI | $329.20 | ↓ -41% |
| Cigna | Commercial | $329.20 | ↓ -41% |
| InterGroup | PPO | $411.50 | ↓ -26% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $452.65 | ↓ -18% |
| Geisinger | Medicaid/CHIP | $452.65 | ↓ -18% |
| Coventry/First Health | Commercial | $576.10 | ↑ +4% |
| Preferred Healthcare System | PPO | $658.40 | ↑ +19% |
| Humana | Commercial | $699.55 | ↑ +26% |
| Private Health Care Systems | PPO | $699.55 | ↑ +26% |
| Multiplan | PPO | $757.16 | ↑ +37% |
| UPMC Health Plan | Managed Medicare | $813.49 | ↑ +47% |
| UPMC Health Plan | Partners/Select | $891.64 | ↑ +61% |
| Aetna of PA | Medicare | $912.67 | ↑ +65% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↑ +69% |
| AmeriHealth Caritas | Medicare | $938.75 | ↑ +69% |
| United Healthcare | Medicare | $938.75 | ↑ +69% |
| Aetna | Medicare | $956.13 | ↑ +72% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Unlisted procedure rectum at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $532.20 | $18.59 – $956.13 |
| UPMC Passavant-McCandless | Pittsburgh | $845.40 | $18.77 – $956.13 |
| UPMC Presbyterian | Pittsburgh | $585.00 | $18.77 – $956.13 |
| UPMC Altoona | Altoona | $121.80 | $18.59 – $938.75 |
| UPMC Bedford | Everett | $791.40 | $48.62 – $1,187.10 |
| UPMC East | Monroeville | $538.20 | $18.77 – $938.75 |
| UPMC Hamot | Erie | $515.40 | $18.59 – $1,264.19 |
| UPMC Jameson | New Castle | $131.40 | $18.92 – $1,173.43 |