healthcosts.net
Bundled special stain group 2 at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$56.40
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.
$94.00
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.
$6.25 with Highmark BCBS of PA vs $135.18 with Aetna — 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 | $6.25 | ↓ -89% |
| UPMC Health Plan | Commercial | $6.47 | ↓ -89% |
| Highmark BCBS of PA | Managed Care - Social Mission | $9.43 | ↓ -83% |
| Highmark BCBS of PA | Managed Care | $12.63 | ↓ -78% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $14.91 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Indemnity | $19.97 | ↓ -65% |
| UPMC Health Plan | CHIP | $23.46 | ↓ -58% |
| Aetna | Neighborhood Network | $26.23 | ↓ -53% |
| Aetna | Home Depot Employer Group | $28.62 | ↓ -49% |
| Aetna | NBR ASO/FI | $29.14 | ↓ -48% |
| Cigna | New Business ASO | $31.96 | ↓ -43% |
| Bravo | Medicare | $32.90 | ↓ -42% |
| Aetna | EBR FI | $35.72 | ↓ -37% |
| Cigna | Commercial | $37.60 | ↓ -33% |
| Aetna | EBR ASO | $37.60 | ↓ -33% |
| Coventry/First Health | Commercial | $41.36 | ↓ -27% |
| UPMC Work Partners | Workers Comp | $41.63 | ↓ -26% |
| InterGroup | PPO | $47.00 | ↓ -17% |
| UPMC Health Plan | Managed Medicaid | $56.11 | ↓ -1% |
| Cigna Behavioral Health | Commercial | $56.40 | ↑ +0% |
| United Healthcare Community Plan for Families | PA Medicaid | $58.66 | ↑ +4% |
| Private Health Care Systems | PPO | $70.50 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $75.20 | ↑ +33% |
| American Healthcare Group | Commercial | $75.20 | ↑ +33% |
| Highmark Wholecare (prev Gateway) | Medicaid | $75.65 | ↑ +34% |
| National Provider Network | PPO | $77.08 | ↑ +37% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $80.72 | ↑ +43% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $84.60 | ↑ +50% |
| Health Payors Organization | Commercial | $84.60 | ↑ +50% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $86.93 | ↑ +54% |
| UPMC Health Plan | Managed Medicare | $102.44 | ↑ +82% |
| Geisinger | Medicaid/CHIP | $122.89 | ↑ +118% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $126.11 | ↑ +124% |
| Aetna of PA | Medicare | $129.03 | ↑ +129% |
| AmeriHealth Caritas | Medicare | $132.72 | ↑ +135% |
| Highmark Wholecare (prev Gateway) | Medicare | $132.72 | ↑ +135% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $132.72 | ↑ +135% |
| Aetna | Medicare | $135.18 | ↑ +140% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bundled special stain group 2 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $229.80 | $6.31 – $135.18 |
| UPMC Presbyterian | Pittsburgh | $557.40 | $6.31 – $135.18 |
| UPMC St. Margaret | Pittsburgh | $114.60 | $6.31 – $162.35 |
| UPMC Muncy | Muncy | $237.60 | $41.44 – $316.80 |
| UPMC Northwest | Seneca | $67.20 | $6.51 – $129.03 |
| UPMC Somerset | Somerset | $78.60 | $6.18 – $65.45 |
| UPMC Wellsboro | Wellsboro | $287.20 | $35.64 – $178.20 |
| UPMC Williamsport | Williamsport | $237.60 | $41.44 – $316.80 |