healthcosts.net
Anal/urinary muscle study at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$580.20
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.
$967.00
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.
$83.39 with Highmark BCBS of PA vs $870.30 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 | $83.39 | ↓ -86% |
| UPMC Health Plan | Managed Medicare | $124.35 | ↓ -79% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $153.08 | ↓ -74% |
| Aetna of PA | Medicare | $156.63 | ↓ -73% |
| AmeriHealth Caritas | Medicare | $161.10 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicare | $161.10 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $161.10 | ↓ -72% |
| Aetna | Medicare | $164.09 | ↓ -72% |
| Highmark BCBS of PA | Managed Care - Social Mission | $187.80 | ↓ -68% |
| Highmark BCBS of PA | Managed Care | $251.49 | ↓ -57% |
| Aetna | Neighborhood Network | $269.79 | ↓ -54% |
| UPMC Work Partners | Workers Comp | $282.05 | ↓ -51% |
| Aetna | Home Depot Employer Group | $294.45 | ↓ -49% |
| Aetna | NBR ASO/FI | $299.77 | ↓ -48% |
| Cigna | New Business ASO | $328.78 | ↓ -43% |
| Bravo | Medicare | $338.45 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $353.08 | ↓ -39% |
| Aetna | EBR FI | $367.46 | ↓ -37% |
| UPMC Health Plan | Commercial | $380.22 | ↓ -34% |
| Cigna | Commercial | $386.80 | ↓ -33% |
| Aetna | EBR ASO | $386.80 | ↓ -33% |
| Coventry/First Health | Commercial | $425.48 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Indemnity | $472.86 | ↓ -19% |
| InterGroup | PPO | $483.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $531.85 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $580.20 | ↑ +0% |
| UPMC Health Plan | CHIP | $605.19 | ↑ +4% |
| Private Health Care Systems | PPO | $725.25 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $773.60 | ↑ +33% |
| American Healthcare Group | Commercial | $773.60 | ↑ +33% |
| National Provider Network | PPO | $792.94 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $870.30 | ↑ +50% |
| Health Payors Organization | Commercial | $870.30 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |