healthcosts.net
_afb org id by sequencing rflx ast-sendout at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,062.00
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.
$1,770.00
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.
$51.03 with UPMC Health Plan vs $1,593.00 with Health Payors Organization — 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 | Commercial | $51.03 | ↓ -95% |
| UPMC Health Plan | Managed Medicare | $96.16 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $114.02 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $115.36 | ↓ -89% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $118.38 | ↓ -89% |
| Aetna of PA | Medicare | $121.13 | ↓ -89% |
| AmeriHealth Caritas | Medicare | $124.59 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $124.59 | ↓ -88% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $124.59 | ↓ -88% |
| Aetna | Medicare | $126.90 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $145.40 | ↓ -86% |
| United Healthcare Community Plan for Families | PA Medicaid | $152.01 | ↓ -86% |
| UPMC Health Plan | CHIP | $184.97 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $196.02 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $209.16 | ↓ -80% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $225.26 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $307.11 | ↓ -71% |
| Highmark BCBS of PA | Managed Care - Social Mission | $463.81 | ↓ -56% |
| Aetna | Neighborhood Network | $493.83 | ↓ -54% |
| Aetna | Home Depot Employer Group | $538.97 | ↓ -49% |
| Aetna | NBR ASO/FI | $548.70 | ↓ -48% |
| Cigna | New Business ASO | $601.80 | ↓ -43% |
| Bravo | Medicare | $619.50 | ↓ -42% |
| Highmark BCBS of PA | Managed Care | $621.10 | ↓ -42% |
| Aetna | EBR FI | $672.60 | ↓ -37% |
| Cigna | Commercial | $708.00 | ↓ -33% |
| Aetna | EBR ASO | $708.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $733.08 | ↓ -31% |
| Coventry/First Health | Commercial | $778.80 | ↓ -27% |
| InterGroup | PPO | $885.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $981.77 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $1,062.00 | ↑ +0% |
| Private Health Care Systems | PPO | $1,327.50 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $1,416.00 | ↑ +33% |
| American Healthcare Group | Commercial | $1,416.00 | ↑ +33% |
| National Provider Network | PPO | $1,451.40 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,593.00 | ↑ +50% |
| Health Payors Organization | Commercial | $1,593.00 | ↑ +50% |
Visitor-reported prices
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_afb org id by sequencing rflx ast-sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,327.80 | $51.33 – $1,881.05 |
| UPMC Presbyterian | Pittsburgh | $574.80 | $54.16 – $814.30 |
| UPMC St. Margaret | Pittsburgh | $1,266.00 | $51.46 – $1,793.50 |
| UPMC Muncy | Muncy | $1,507.80 | $114.02 – $2,010.40 |
| UPMC Northwest | Seneca | $1,823.40 | $51.36 – $2,583.15 |
| UPMC Somerset | Somerset | $642.60 | $114.02 – $803.25 |
| UPMC Wellsboro | Wellsboro | $1,823.20 | $114.02 – $2,051.10 |
| UPMC Williamsport | Williamsport | $1,507.80 | $114.02 – $2,010.40 |