healthcosts.net
#cf-97variants at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$3,357.60
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.
$5,596.00
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.
$256.16 with UPMC Health Plan vs $2,452.23 with Highmark BCBS of PA — 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 | Commercial | $256.16 | ↓ -92% |
| Aetna | Neighborhood Network | $339.54 | ↓ -90% |
| Aetna | Home Depot Employer Group | $370.58 | ↓ -89% |
| Aetna | NBR ASO/FI | $377.27 | ↓ -89% |
| Cigna | New Business ASO | $413.78 | ↓ -88% |
| Bravo | Medicare | $425.95 | ↓ -87% |
| Aetna | EBR FI | $462.46 | ↓ -86% |
| UPMC Health Plan | Managed Medicare | $463.98 | ↓ -86% |
| Cigna | Commercial | $486.80 | ↓ -86% |
| Aetna | EBR ASO | $486.80 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $489.81 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $512.07 | ↓ -85% |
| Coventry/First Health | Commercial | $535.48 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $550.10 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $556.60 | ↓ -83% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $571.18 | ↓ -83% |
| Aetna of PA | Medicare | $584.43 | ↓ -83% |
| AmeriHealth Caritas | Medicare | $601.13 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicare | $601.13 | ↓ -82% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $601.13 | ↓ -82% |
| InterGroup | PPO | $608.50 | ↓ -82% |
| Aetna | Medicare | $612.26 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $660.35 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $704.61 | ↓ -79% |
| Cigna Behavioral Health | Commercial | $730.20 | ↓ -78% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $758.85 | ↓ -77% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $767.09 | ↓ -77% |
| Private Health Care Systems | PPO | $912.75 | ↓ -73% |
| UPMC Health Plan | CHIP | $928.48 | ↓ -72% |
| InterGroup | Approved National Affiliated PPO Business | $973.60 | ↓ -71% |
| American Healthcare Group | Commercial | $973.60 | ↓ -71% |
| National Provider Network | PPO | $997.94 | ↓ -70% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,095.30 | ↓ -67% |
| Health Payors Organization | Commercial | $1,095.30 | ↓ -67% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,158.48 | ↓ -65% |
| Highmark BCBS of PA | Managed Care | $1,551.35 | ↓ -54% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,831.06 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,452.23 | ↓ -27% |
Visitor-reported prices
Comments
#cf-97variants at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,357.60 | $257.67 – $1,096.50 |
| UPMC Presbyterian | Pittsburgh | $5,034.60 | $271.88 – $1,034.45 |
| UPMC St. Margaret | Pittsburgh | $3,357.60 | $258.30 – $1,034.45 |
| UPMC Muncy | Muncy | $2,487.60 | $54.75 – $569.96 |
| UPMC Northwest | Seneca | $3,357.60 | $257.79 – $674.05 |
| UPMC Somerset | Somerset | $3,216.00 | $489.81 – $4,020.00 |
| UPMC Wellsboro | Wellsboro | $3,108.00 | $62.64 – $671.48 |
| UPMC Williamsport | Williamsport | $3,263.40 | $119.61 – $601.13 |