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Acyclovir 400 mg tablet at UPMC Mercy

1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

not published by hospital

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$454.60

Gross charge

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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.

$0.15 with Aetna vs $0.54 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 →

Payer
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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
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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
Aetna Medicare $0.15
Aetna Neighborhood Network $0.17
Aetna Home Depot Employer Group $0.18
Aetna NBR ASO/FI $0.19
Cigna New Business ASO $0.20
Bravo Medicare $0.21
UPMC Health Plan CHIP $0.21
UPMC Work Partners Workers Comp $0.21
Aetna EBR FI $0.23
Aetna EBR ASO $0.24
Cigna Commercial $0.24
Coventry/First Health Commercial $0.26
UPMC Health Plan Commercial $0.27
Highmark BCBS of PA Managed Care $0.28
Highmark BCBS of PA Managed Care - Social Mission $0.28
Highmark BCBS of PA Commercial - Indemnity $0.29
Highmark BCBS of PA Commercial - Social Mission Indemnity $0.29
Highmark BCBS of PA Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage $0.30
Highmark Wholecare (prev Gateway) Medicare $0.30
InterGroup PPO $0.30
PA Health & Wellness Community Health Choices/PA Medicaid HMO $0.33
Cigna Behavioral Health Commercial $0.36
Private Health Care Systems PPO $0.45
American Healthcare Group Commercial $0.48
InterGroup Approved National Affiliated PPO Business $0.48
National Provider Network PPO $0.49
Health Payors Organization Commercial $0.54
Multiplan PPO (inc. Auto and Worker's Compensation) $0.54

Visitor-reported prices

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Acyclovir 400 mg tablet at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC St. Margaret Pittsburgh not published $0.04 – $0.51
UPMC Williamsport Williamsport $13.20 $5.94 – $19.80
UPMC Northwest Seneca not published $0.04 – $0.51

All Pennsylvania hospitals for this procedure →