healthcosts.net
Angio tib/peroneal/init ves/unila 37228 at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$37,499.40
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.
$62,499.00
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.
$518.43 with UPMC Health Plan vs $60,138.10 with Highmark BCBS of PA — 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 | Managed Medicaid | $518.43 | ↓ -99% |
| United Healthcare Community Plan for Families | PA Medicaid | $542.00 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $698.94 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $745.79 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $803.19 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $8,995.26 | ↓ -76% |
| UPMC Health Plan | Managed Medicare | $9,012.77 | ↓ -76% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $9,708.25 | ↓ -74% |
| UPMC Health Plan | Commercial | $10,067.17 | ↓ -73% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,095.14 | ↓ -70% |
| Aetna of PA | Medicare | $11,352.46 | ↓ -70% |
| AmeriHealth Caritas | Medicare | $11,676.82 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,676.82 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,676.82 | ↓ -69% |
| Aetna | Medicare | $11,893.06 | ↓ -68% |
| Aetna | Neighborhood Network | $17,437.22 | ↓ -54% |
| UPMC Health Plan | CHIP | $18,211.70 | ↓ -51% |
| Aetna | Home Depot Employer Group | $19,030.95 | ↓ -49% |
| Aetna | NBR ASO/FI | $19,374.69 | ↓ -48% |
| Cigna | New Business ASO | $21,249.66 | ↓ -43% |
| Highmark BCBS of PA | Managed Care - Social Mission | $21,864.98 | ↓ -42% |
| Bravo | Medicare | $21,874.65 | ↓ -42% |
| Aetna | EBR FI | $23,749.62 | ↓ -37% |
| Cigna | Commercial | $24,999.60 | ↓ -33% |
| Aetna | EBR ASO | $24,999.60 | ↓ -33% |
| Coventry/First Health | Commercial | $27,499.56 | ↓ -27% |
| Highmark BCBS of PA | Managed Care | $29,280.40 | ↓ -22% |
| InterGroup | PPO | $31,249.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $37,499.40 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $44,905.63 | ↑ +20% |
| Private Health Care Systems | PPO | $46,874.25 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $49,999.20 | ↑ +33% |
| American Healthcare Group | Commercial | $49,999.20 | ↑ +33% |
| National Provider Network | PPO | $51,249.18 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $56,249.10 | ↑ +50% |
| Health Payors Organization | Commercial | $56,249.10 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Indemnity | $60,138.10 | ↑ +60% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Angio tib/peroneal/init ves/unila 37228 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $59,645.40 | $7,969.78 – $84,497.65 |
| UPMC Presbyterian | Pittsburgh | $30,499.20 | $518.43 – $43,207.20 |
| UPMC St. Margaret | Pittsburgh | $29,775.00 | $7,969.78 – $42,181.25 |
| UPMC Northwest | Seneca | $37,266.60 | $7,969.78 – $52,794.35 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $4,394.40 | $993.28 – $11,675.74 |