healthcosts.net
Complx repair enel addl 5cm/< 13153 at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,434.60
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.
$2,391.00
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.
$306.39 with Highmark BCBS of PA vs $2,151.90 with Multiplan — 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 | $306.39 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $317.25 | ↓ -78% |
| UPMC Health Plan | Commercial | $494.81 | ↓ -66% |
| Aetna | Medicare | $597.75 | ↓ -58% |
| Aetna | Neighborhood Network | $667.09 | ↓ -53% |
| Private Health Care Systems | PPO | $681.00 | ↓ -53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $690.04 | ↓ -52% |
| Aetna | Home Depot Employer Group | $728.06 | ↓ -49% |
| Aetna | NBR ASO/FI | $741.21 | ↓ -48% |
| UPMC Health Plan | CHIP | $787.58 | ↓ -45% |
| Cigna | New Business ASO | $812.94 | ↓ -43% |
| Bravo | Medicare | $836.85 | ↓ -42% |
| Aetna | EBR FI | $908.58 | ↓ -37% |
| Highmark BCBS of PA | Managed Care | $924.07 | ↓ -36% |
| Aetna | EBR ASO | $956.40 | ↓ -33% |
| Cigna | Commercial | $956.40 | ↓ -33% |
| Coventry/First Health | Commercial | $1,052.04 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,195.50 | ↓ -17% |
| InterGroup | PPO | $1,195.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,315.05 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,417.19 | ↓ -1% |
| Cigna Behavioral Health | Commercial | $1,434.60 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,897.92 | ↑ +32% |
| American Healthcare Group | Commercial | $1,912.80 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $1,912.80 | ↑ +33% |
| National Provider Network | PPO | $1,960.62 | ↑ +37% |
| Health Payors Organization | Commercial | $2,151.90 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $2,151.90 | ↑ +50% |
Visitor-reported prices
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Complx repair enel addl 5cm/< 13153 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,606.80 | $287.80 – $2,276.30 |
| UPMC Presbyterian | Pittsburgh | $2,219.40 | $142.16 – $3,144.15 |
| UPMC St. Margaret | Pittsburgh | $1,750.80 | $287.80 – $2,480.30 |
| UPMC Muncy | Muncy | $660.00 | $151.64 – $880.00 |
| UPMC Somerset | Somerset | $319.20 | $136.24 – $471.73 |
| UPMC Wellsboro | Wellsboro | $798.40 | $151.64 – $898.20 |