healthcosts.net
Bilirubin total at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$58.80
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.
?
What you pay up front if you don't use insurance.
$98.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$4.18 with UPMC Health Plan vs $88.20 with Health Payors Organization — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 Medicare | $4.18 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $4.96 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $5.02 | ↓ -91% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $5.15 | ↓ -91% |
| Aetna of PA | Medicare | $5.27 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $5.42 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $5.42 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5.42 | ↓ -91% |
| Aetna | Medicare | $5.52 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $7.62 | ↓ -87% |
| United Healthcare Community Plan for Families | PA Medicaid | $7.97 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $10.28 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $10.97 | ↓ -81% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $11.81 | ↓ -80% |
| UPMC Health Plan | Commercial | $12.47 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $13.33 | ↓ -77% |
| Highmark BCBS of PA | Managed Care - Social Mission | $20.13 | ↓ -66% |
| Highmark BCBS of PA | Managed Care | $26.95 | ↓ -54% |
| Aetna | Neighborhood Network | $27.34 | ↓ -54% |
| Aetna | Home Depot Employer Group | $29.84 | ↓ -49% |
| Aetna | NBR ASO/FI | $30.38 | ↓ -48% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $31.81 | ↓ -46% |
| Cigna | New Business ASO | $33.32 | ↓ -43% |
| Bravo | Medicare | $34.30 | ↓ -42% |
| Aetna | EBR FI | $37.24 | ↓ -37% |
| Cigna | Commercial | $39.20 | ↓ -33% |
| Aetna | EBR ASO | $39.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $42.61 | ↓ -28% |
| Coventry/First Health | Commercial | $43.12 | ↓ -27% |
| UPMC Health Plan | CHIP | $45.19 | ↓ -23% |
| InterGroup | PPO | $49.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $58.80 | ↑ +0% |
| Private Health Care Systems | PPO | $73.50 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $78.40 | ↑ +33% |
| American Healthcare Group | Commercial | $78.40 | ↑ +33% |
| National Provider Network | PPO | $80.36 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $88.20 | ↑ +50% |
| Health Payors Organization | Commercial | $88.20 | ↑ +50% |
Visitor-reported prices
Comments
Bilirubin total at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $126.60 | $4.67 – $179.35 |
| UPMC Presbyterian | Pittsburgh | $231.60 | $4.96 – $328.10 |
| UPMC St. Margaret | Pittsburgh | $66.60 | $4.33 – $94.35 |
| UPMC Muncy | Muncy | $133.80 | $4.96 – $101.60 |
| UPMC Northwest | Seneca | $33.00 | $4.55 – $46.75 |
| UPMC Somerset | Somerset | $25.20 | $4.96 – $26.25 |
| UPMC Wellsboro | Wellsboro | $161.60 | $4.96 – $102.60 |
| UPMC Williamsport | Williamsport | $75.60 | $4.96 – $100.80 |