healthcosts.net
C-peptide at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$315.00
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.
$525.00
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.
$17.35 with UPMC Health Plan vs $472.50 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 | Managed Medicare | $17.35 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $20.57 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $20.81 | ↓ -93% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $21.36 | ↓ -93% |
| Aetna of PA | Medicare | $21.85 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $22.47 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $22.47 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $22.47 | ↓ -93% |
| Aetna | Medicare | $22.89 | ↓ -93% |
| UPMC Health Plan | Commercial | $29.82 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $31.62 | ↓ -90% |
| United Healthcare Community Plan for Families | PA Medicaid | $33.06 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $40.21 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $42.64 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $45.49 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $49.00 | ↓ -84% |
| Highmark BCBS of PA | Managed Care - Social Mission | $60.72 | ↓ -81% |
| Highmark BCBS of PA | Managed Care | $81.31 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $95.97 | ↓ -70% |
| UPMC Health Plan | CHIP | $108.08 | ↓ -66% |
| Highmark BCBS of PA | Commercial - Indemnity | $128.53 | ↓ -59% |
| Aetna | Neighborhood Network | $146.47 | ↓ -54% |
| Aetna | Home Depot Employer Group | $159.86 | ↓ -49% |
| Aetna | NBR ASO/FI | $162.75 | ↓ -48% |
| Cigna | New Business ASO | $178.50 | ↓ -43% |
| Bravo | Medicare | $183.75 | ↓ -42% |
| Aetna | EBR FI | $199.50 | ↓ -37% |
| Cigna | Commercial | $210.00 | ↓ -33% |
| Aetna | EBR ASO | $210.00 | ↓ -33% |
| Coventry/First Health | Commercial | $231.00 | ↓ -27% |
| InterGroup | PPO | $262.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $315.00 | ↑ +0% |
| Private Health Care Systems | PPO | $393.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $420.00 | ↑ +33% |
| American Healthcare Group | Commercial | $420.00 | ↑ +33% |
| National Provider Network | PPO | $430.50 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $472.50 | ↑ +50% |
| Health Payors Organization | Commercial | $472.50 | ↑ +50% |
Visitor-reported prices
Comments
C-peptide at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $249.60 | $19.34 – $353.60 |
| UPMC Presbyterian | Pittsburgh | $451.80 | $20.57 – $640.05 |
| UPMC St. Margaret | Pittsburgh | $156.60 | $17.97 – $221.85 |
| UPMC Muncy | Muncy | $348.60 | $20.57 – $464.80 |
| UPMC Northwest | Seneca | $102.60 | $18.87 – $145.35 |
| UPMC Somerset | Somerset | $120.00 | $20.57 – $131.25 |
| UPMC Wellsboro | Wellsboro | $421.60 | $20.57 – $257.40 |
| UPMC Williamsport | Williamsport | $189.00 | $20.57 – $252.00 |