healthcosts.net
#creutz-prot.,western blot at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$190.20
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.
$317.00
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.
$24.35 with UPMC Health Plan vs $285.30 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicare | $24.35 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $27.00 | ↓ -86% |
| United Healthcare Community Plan for Families | PA Medicaid | $28.23 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $28.87 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $29.21 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $29.98 | ↓ -84% |
| Aetna of PA | Medicare | $30.67 | ↓ -84% |
| AmeriHealth Caritas | Medicare | $31.55 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $31.55 | ↓ -83% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $31.55 | ↓ -83% |
| Aetna | Medicare | $32.13 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $36.41 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $38.85 | ↓ -80% |
| UPMC Health Plan | Commercial | $41.62 | ↓ -78% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $41.84 | ↓ -78% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $48.92 | ↓ -74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $73.89 | ↓ -61% |
| Aetna | Neighborhood Network | $88.44 | ↓ -54% |
| Aetna | Home Depot Employer Group | $96.53 | ↓ -49% |
| Aetna | NBR ASO/FI | $98.27 | ↓ -48% |
| Highmark BCBS of PA | Managed Care | $98.94 | ↓ -48% |
| Cigna | New Business ASO | $107.78 | ↓ -43% |
| Bravo | Medicare | $110.95 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $116.78 | ↓ -39% |
| Aetna | EBR FI | $120.46 | ↓ -37% |
| Cigna | Commercial | $126.80 | ↓ -33% |
| Aetna | EBR ASO | $126.80 | ↓ -33% |
| Coventry/First Health | Commercial | $139.48 | ↓ -27% |
| UPMC Health Plan | CHIP | $150.86 | ↓ -21% |
| Highmark BCBS of PA | Commercial - Indemnity | $156.40 | ↓ -18% |
| InterGroup | PPO | $158.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $190.20 | ↑ +0% |
| Private Health Care Systems | PPO | $237.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $253.60 | ↑ +33% |
| American Healthcare Group | Commercial | $253.60 | ↑ +33% |
| National Provider Network | PPO | $259.94 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $285.30 | ↑ +50% |
| Health Payors Organization | Commercial | $285.30 | ↑ +50% |
Visitor-reported prices
Comments
#creutz-prot.,western blot at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $571.20 | $27.00 – $808.35 |
| UPMC St. Margaret | Pittsburgh | $1,726.80 | $25.22 – $2,446.30 |
| UPMC Muncy | Muncy | $146.40 | $27.00 – $195.20 |
| UPMC Northwest | Seneca | $166.20 | $26.49 – $235.45 |
| UPMC Somerset | Somerset | $147.60 | $27.00 – $184.50 |
| UPMC Wellsboro | Wellsboro | $176.80 | $24.55 – $198.90 |
| UPMC Williamsport | Williamsport | $146.40 | $27.00 – $195.20 |