healthcosts.net
Cable cath 22-pin diag at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,274.40
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.
$2,124.00
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.
$160.08 with Highmark Wholecare (prev Gateway) vs $2,165.24 with UPMC Health Plan — 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 Wholecare (prev Gateway) | Medicaid | $160.08 | ↓ -87% |
| Aetna | Medicare | $166.75 | ↓ -87% |
| Aetna | Neighborhood Network | $186.09 | ↓ -85% |
| Aetna | Home Depot Employer Group | $203.10 | ↓ -84% |
| Aetna | NBR ASO/FI | $206.77 | ↓ -84% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $220.11 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $225.65 | ↓ -82% |
| Cigna | New Business ASO | $226.78 | ↓ -82% |
| Aetna | EBR FI | $253.46 | ↓ -80% |
| Aetna | EBR ASO | $266.80 | ↓ -79% |
| Cigna | Commercial | $266.80 | ↓ -79% |
| Coventry/First Health | Commercial | $293.48 | ↓ -77% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $299.12 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicare | $333.50 | ↓ -74% |
| InterGroup | PPO | $333.50 | ↓ -74% |
| Cigna Behavioral Health | Commercial | $400.20 | ↓ -69% |
| Highmark BCBS of PA | Managed Care - Social Mission | $451.73 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $459.94 | ↓ -64% |
| Private Health Care Systems | PPO | $500.25 | ↓ -61% |
| American Healthcare Group | Commercial | $533.60 | ↓ -58% |
| InterGroup | Approved National Affiliated PPO Business | $533.60 | ↓ -58% |
| National Provider Network | PPO | $546.94 | ↓ -57% |
| Health Payors Organization | Commercial | $600.30 | ↓ -53% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $600.30 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $604.93 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $615.91 | ↓ -52% |
| Bravo | Medicare | $743.40 | ↓ -42% |
| UPMC Health Plan | Commercial | $1,709.77 | ↑ +34% |
| UPMC Health Plan | CHIP | $2,165.24 | ↑ +70% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Cable cath 22-pin diag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,353.60 | $32.25 – $3,142.03 |
| UPMC Presbyterian | Pittsburgh | $11,776.20 | $25.74 – $3,500.81 |
| UPMC St. Margaret | Pittsburgh | $109.80 | $45.75 – $2,656.90 |
| UPMC Somerset | Somerset | $2,526.60 | $101.99 – $1,296.90 |
| UPMC Williamsport | Williamsport | $2,604.00 | $232.47 – $774.90 |