healthcosts.net
Alteplase 100 mg infusion from pyxis vial at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$612.00
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.
$20,518.05
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.
$48.57 with Highmark BCBS of PA vs $212.40 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $48.57 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $59.63 | ↓ -90% |
| Aetna | Neighborhood Network | $65.84 | ↓ -89% |
| Aetna | Home Depot Employer Group | $71.86 | ↓ -88% |
| Aetna | NBR ASO/FI | $73.16 | ↓ -88% |
| UPMC Health Plan | Managed Medicare | $78.73 | ↓ -87% |
| Cigna | New Business ASO | $80.24 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $81.96 | ↓ -87% |
| Bravo | Medicare | $82.60 | ↓ -87% |
| Aetna | EBR FI | $89.68 | ↓ -85% |
| Cigna | Commercial | $94.40 | ↓ -85% |
| Aetna | EBR ASO | $94.40 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $94.45 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $94.45 | ↓ -85% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $94.45 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $96.92 | ↓ -84% |
| Aetna of PA | Medicare | $99.17 | ↓ -84% |
| AmeriHealth Caritas | Medicare | $102.01 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $102.01 | ↓ -83% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $102.01 | ↓ -83% |
| UPMC Health Plan | CHIP | $103.24 | ↓ -83% |
| Coventry/First Health | Commercial | $103.84 | ↓ -83% |
| Aetna | Medicare | $103.89 | ↓ -83% |
| UPMC Health Plan | Commercial | $116.17 | ↓ -81% |
| InterGroup | PPO | $118.00 | ↓ -81% |
| Highmark BCBS of PA | Managed Care - Social Mission | $138.20 | ↓ -77% |
| Cigna Behavioral Health | Commercial | $141.60 | ↓ -77% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $142.13 | ↓ -77% |
| Private Health Care Systems | PPO | $177.00 | ↓ -71% |
| Highmark BCBS of PA | Managed Care | $185.09 | ↓ -70% |
| InterGroup | Approved National Affiliated PPO Business | $188.80 | ↓ -69% |
| American Healthcare Group | Commercial | $188.80 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Indemnity | $190.36 | ↓ -69% |
| National Provider Network | PPO | $193.52 | ↓ -68% |
| United Healthcare Community Plan for Families | PA Medicaid | $204.13 | ↓ -67% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $212.40 | ↓ -65% |
| Health Payors Organization | Commercial | $212.40 | ↓ -65% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Alteplase 100 mg infusion from pyxis vial at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $285.00 | $49.03 – $346.80 |
| UPMC St. Margaret | Pittsburgh | $540.80 | $49.03 – $306.85 |
| UPMC Western Psychiatric | Pittsburgh | $285.00 | $48.05 – $370.60 |
| UPMC Passavant-McCandless | Pittsburgh | $39,117.00 | $49.03 – $255.85 |
| UPMC Somerset | Somerset | $5,280.00 | $29.63 – $94.45 |
| UPMC Williamsport | Williamsport | $543.20 | $94.45 – $531.90 |
| UPMC Muncy | Muncy | $40,758.00 | $88.65 – $531.90 |
| UPMC Wellsboro | Wellsboro | $40,758.00 | $94.45 – $531.90 |