healthcosts.net
Clozapine, 25 mg at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$5.40
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.
$6.75
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.
$0.31 with United Healthcare Community Plan for Families vs $9.11 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $0.31 | ↓ -94% |
| Aetna | Medicare | $0.38 | ↓ -93% |
| Aetna | Neighborhood Network | $0.42 | ↓ -92% |
| Aetna | Home Depot Employer Group | $0.46 | ↓ -91% |
| Aetna | NBR ASO/FI | $0.47 | ↓ -91% |
| Cigna | New Business ASO | $0.51 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $0.52 | ↓ -90% |
| Bravo | Medicare | $0.53 | ↓ -90% |
| Aetna | EBR FI | $0.57 | ↓ -89% |
| Aetna | EBR ASO | $0.60 | ↓ -89% |
| Cigna | Commercial | $0.60 | ↓ -89% |
| Coventry/First Health | Commercial | $0.66 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $0.75 | ↓ -86% |
| InterGroup | PPO | $0.75 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $0.83 | ↓ -85% |
| Cigna Behavioral Health | Commercial | $0.90 | ↓ -83% |
| Private Health Care Systems | PPO | $1.12 | ↓ -79% |
| American Healthcare Group | Commercial | $1.20 | ↓ -78% |
| InterGroup | Approved National Affiliated PPO Business | $1.20 | ↓ -78% |
| National Provider Network | PPO | $1.23 | ↓ -77% |
| Health Payors Organization | Commercial | $1.35 | ↓ -75% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1.35 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $2.32 | ↓ -57% |
| UPMC Health Plan | Commercial | $4.38 | ↓ -19% |
| UPMC Health Plan | CHIP | $5.54 | ↑ +3% |
| Highmark BCBS of PA | Managed Care - Social Mission | $6.61 | ↑ +22% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6.80 | ↑ +26% |
| Highmark BCBS of PA | Managed Care | $8.85 | ↑ +64% |
| Highmark BCBS of PA | Commercial - Indemnity | $9.11 | ↑ +69% |
Visitor-reported prices
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Clozapine, 25 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $18.60 | $0.28 – $8.05 |
| UPMC Presbyterian | Pittsburgh | $18.60 | $0.27 – $8.96 |
| UPMC St. Margaret | Pittsburgh | $7.60 | $0.29 – $6.80 |
| UPMC Western Psychiatric | Pittsburgh | $18.60 | $2.19 – $7.44 |
| UPMC Muncy | Muncy | $8.40 | $0.98 – $5.85 |
| UPMC Northwest | Seneca | $17.40 | $0.28 – $6.71 |
| UPMC Wellsboro | Wellsboro | $8.40 | $0.27 – $5.85 |
| UPMC Williamsport | Williamsport | $8.40 | $1.75 – $5.85 |