healthcosts.net
Boot j walker l at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$950.40
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.
$1,584.00
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.
$231.57 with Highmark BCBS of PA vs $1,425.60 with Multiplan — 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 | $231.57 | ↓ -76% |
| UPMC Work Partners | Workers Comp | $241.75 | ↓ -75% |
| Highmark BCBS of PA | Managed Care - Social Mission | $349.72 | ↓ -63% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $356.07 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicaid | $380.16 | ↓ -60% |
| Aetna | Medicare | $396.00 | ↓ -58% |
| Aetna | Neighborhood Network | $441.94 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $468.32 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Indemnity | $476.82 | ↓ -50% |
| Aetna | Home Depot Employer Group | $482.33 | ↓ -49% |
| Aetna | NBR ASO/FI | $491.04 | ↓ -48% |
| Cigna | New Business ASO | $538.56 | ↓ -43% |
| UPMC Health Plan | Commercial | $589.50 | ↓ -38% |
| Aetna | EBR FI | $601.92 | ↓ -37% |
| Aetna | EBR ASO | $633.60 | ↓ -33% |
| Cigna | Commercial | $633.60 | ↓ -33% |
| Coventry/First Health | Commercial | $696.96 | ↓ -27% |
| UPMC Health Plan | CHIP | $746.54 | ↓ -21% |
| Highmark Wholecare (prev Gateway) | Medicare | $792.00 | ↓ -17% |
| InterGroup | PPO | $792.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $871.20 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $950.40 | ↑ +0% |
| Private Health Care Systems | PPO | $1,188.00 | ↑ +25% |
| American Healthcare Group | Commercial | $1,267.20 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $1,267.20 | ↑ +33% |
| National Provider Network | PPO | $1,298.88 | ↑ +37% |
| Health Payors Organization | Commercial | $1,425.60 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,425.60 | ↑ +50% |
| Bravo | Medicare | not published by hospital | — |
Visitor-reported prices
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Boot j walker l at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,537.20 | $233.77 – $1,923.55 |
| UPMC Presbyterian | Pittsburgh | $1,179.00 | $149.50 – $1,670.25 |
| UPMC St. Margaret | Pittsburgh | $1,519.80 | $233.77 – $2,153.05 |
| UPMC Muncy | Muncy | $1,417.80 | $159.46 – $1,890.40 |
| UPMC Northwest | Seneca | $1,516.20 | $241.75 – $2,147.95 |
| UPMC Wellsboro | Wellsboro | $1,714.40 | $159.46 – $1,928.70 |
| UPMC Williamsport | Williamsport | $1,417.80 | $159.46 – $1,890.40 |