healthcosts.net
Analysis gene f2 20210g>a variant at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$2,503.20
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.
$4,172.00
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.
$28.91 with UPMC Health Plan vs $420.30 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $28.91 | ↓ -99% |
| UPMC Health Plan | Managed Medicare | $54.76 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $59.07 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $61.76 | ↓ -98% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $63.44 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $64.92 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $65.69 | ↓ -97% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $67.41 | ↓ -97% |
| Aetna of PA | Medicare | $68.97 | ↓ -97% |
| AmeriHealth Caritas | Medicare | $70.95 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicare | $70.95 | ↓ -97% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $70.95 | ↓ -97% |
| Aetna | Medicare | $72.26 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $79.64 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $84.97 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $91.52 | ↓ -96% |
| Highmark BCBS of PA | Managed Care - Social Mission | $95.81 | ↓ -96% |
| UPMC Health Plan | CHIP | $104.78 | ↓ -96% |
| Highmark BCBS of PA | Managed Care | $128.30 | ↓ -95% |
| Aetna | Neighborhood Network | $130.29 | ↓ -95% |
| Aetna | Home Depot Employer Group | $142.20 | ↓ -94% |
| Aetna | NBR ASO/FI | $144.77 | ↓ -94% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $151.43 | ↓ -94% |
| Cigna | New Business ASO | $158.78 | ↓ -94% |
| Bravo | Medicare | $163.45 | ↓ -93% |
| Aetna | EBR FI | $177.46 | ↓ -93% |
| Cigna | Commercial | $186.80 | ↓ -93% |
| Aetna | EBR ASO | $186.80 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Indemnity | $202.81 | ↓ -92% |
| Coventry/First Health | Commercial | $205.48 | ↓ -92% |
| InterGroup | PPO | $233.50 | ↓ -91% |
| Cigna Behavioral Health | Commercial | $280.20 | ↓ -89% |
| Private Health Care Systems | PPO | $350.25 | ↓ -86% |
| InterGroup | Approved National Affiliated PPO Business | $373.60 | ↓ -85% |
| American Healthcare Group | Commercial | $373.60 | ↓ -85% |
| National Provider Network | PPO | $382.94 | ↓ -85% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $420.30 | ↓ -83% |
| Health Payors Organization | Commercial | $420.30 | ↓ -83% |
Visitor-reported prices
Comments
Analysis gene f2 20210g>a variant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,697.40 | $29.08 – $396.95 |
| UPMC Presbyterian | Pittsburgh | $2,503.20 | $30.68 – $589.90 |
| UPMC St. Margaret | Pittsburgh | $2,503.20 | $29.15 – $396.95 |
| UPMC Muncy | Muncy | $2,361.60 | $48.90 – $260.80 |
| UPMC Northwest | Seneca | $2,503.20 | $29.09 – $396.95 |
| UPMC Somerset | Somerset | $380.40 | $59.07 – $475.50 |
| UPMC Wellsboro | Wellsboro | $2,361.60 | $53.70 – $279.00 |
| UPMC Williamsport | Williamsport | $2,479.80 | $59.07 – $316.80 |