healthcosts.net
Correct rectal prolapse at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$8,616.60
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.
$14,361.00
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.
$1,413.84 with Highmark BCBS of PA vs $12,924.90 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,413.84 | ↓ -84% |
| UPMC Health Plan | Commercial | $1,949.28 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $2,179.48 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $2,265.55 | ↓ -74% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $2,683.04 | ↓ -69% |
| Aetna of PA | Medicare | $2,745.27 | ↓ -68% |
| AmeriHealth Caritas | Medicare | $2,823.70 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,823.70 | ↓ -67% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,823.70 | ↓ -67% |
| Aetna | Medicare | $2,875.99 | ↓ -67% |
| UPMC Health Plan | CHIP | $3,102.62 | ↓ -64% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,184.26 | ↓ -63% |
| Aetna | Neighborhood Network | $4,006.72 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $4,264.19 | ↓ -51% |
| Aetna | Home Depot Employer Group | $4,372.92 | ↓ -49% |
| Aetna | NBR ASO/FI | $4,451.91 | ↓ -48% |
| Cigna | New Business ASO | $4,882.74 | ↓ -43% |
| Bravo | Medicare | $5,026.35 | ↓ -42% |
| Aetna | EBR FI | $5,457.18 | ↓ -37% |
| Cigna | Commercial | $5,744.40 | ↓ -33% |
| Aetna | EBR ASO | $5,744.40 | ↓ -33% |
| Coventry/First Health | Commercial | $6,318.84 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6,539.73 | ↓ -24% |
| InterGroup | PPO | $7,180.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $7,898.55 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $8,616.60 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity | $8,758.08 | ↑ +2% |
| Private Health Care Systems | PPO | $10,770.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $11,488.80 | ↑ +33% |
| American Healthcare Group | Commercial | $11,488.80 | ↑ +33% |
| National Provider Network | PPO | $11,776.02 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $12,924.90 | ↑ +50% |
| Health Payors Organization | Commercial | $12,924.90 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Correct rectal prolapse at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $10,834.80 | $931.20 – $15,349.30 |
| UPMC St. Margaret | Pittsburgh | $7,807.80 | $1,392.47 – $11,061.05 |
| UPMC Williamsport | Williamsport | $8,777.40 | $993.28 – $11,703.20 |