healthcosts.net
Analysis gene f5 leiden variant at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,251.60
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.
$2,086.00
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 $1,787.40 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $28.91 | ↓ -98% |
| UPMC Health Plan | Managed Medicare | $61.16 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $72.52 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $73.37 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $73.37 | ↓ -94% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $75.29 | ↓ -94% |
| United Healthcare Community Plan for Families | PA Medicaid | $76.70 | ↓ -94% |
| Aetna of PA | Medicare | $77.04 | ↓ -94% |
| AmeriHealth Caritas | Medicare | $79.24 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $79.24 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $79.24 | ↓ -94% |
| Aetna | Medicare | $80.71 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $98.92 | ↓ -92% |
| UPMC Health Plan | CHIP | $104.78 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $105.55 | ↓ -92% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $113.67 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $272.24 | ↓ -78% |
| Highmark BCBS of PA | Managed Care - Social Mission | $411.14 | ↓ -67% |
| Highmark BCBS of PA | Managed Care | $550.57 | ↓ -56% |
| Aetna | Neighborhood Network | $554.09 | ↓ -56% |
| Aetna | Home Depot Employer Group | $604.74 | ↓ -52% |
| Aetna | NBR ASO/FI | $615.66 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $649.84 | ↓ -48% |
| Cigna | New Business ASO | $675.24 | ↓ -46% |
| Bravo | Medicare | $695.10 | ↓ -44% |
| Aetna | EBR FI | $754.68 | ↓ -40% |
| Cigna | Commercial | $794.40 | ↓ -37% |
| Aetna | EBR ASO | $794.40 | ↓ -37% |
| Highmark BCBS of PA | Commercial - Indemnity | $870.29 | ↓ -30% |
| Coventry/First Health | Commercial | $873.84 | ↓ -30% |
| InterGroup | PPO | $993.00 | ↓ -21% |
| Cigna Behavioral Health | Commercial | $1,191.60 | ↓ -5% |
| Private Health Care Systems | PPO | $1,489.50 | ↑ +19% |
| InterGroup | Approved National Affiliated PPO Business | $1,588.80 | ↑ +27% |
| American Healthcare Group | Commercial | $1,588.80 | ↑ +27% |
| National Provider Network | PPO | $1,628.52 | ↑ +30% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,787.40 | ↑ +43% |
| Health Payors Organization | Commercial | $1,787.40 | ↑ +43% |
Visitor-reported prices
Comments
Analysis gene f5 leiden variant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,191.60 | $29.08 – $1,688.10 |
| UPMC Presbyterian | Pittsburgh | $1,788.00 | $30.68 – $409.70 |
| UPMC St. Margaret | Pittsburgh | $1,251.60 | $29.15 – $1,688.10 |
| UPMC Muncy | Muncy | $1,021.80 | $72.52 – $974.40 |
| UPMC Northwest | Seneca | $1,251.60 | $29.09 – $1,688.10 |
| UPMC Somerset | Somerset | $424.80 | $72.27 – $531.00 |
| UPMC Wellsboro | Wellsboro | $1,764.00 | $66.70 – $1,044.00 |
| UPMC Williamsport | Williamsport | $1,217.40 | $72.52 – $1,184.80 |