healthcosts.net
Debridement (>20 cm) charge pt at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$321.00
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.
$535.00
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.
$12.72 with UPMC Health Plan vs $677.62 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 | Managed Medicaid | $12.72 | ↓ -96% |
| United Healthcare Community Plan for Families | PA Medicaid | $13.29 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $17.14 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $18.29 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $19.70 | ↓ -94% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $109.39 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $121.47 | ↓ -62% |
| Aetna | Medicare | $133.75 | ↓ -58% |
| UPMC Health Plan | Commercial | $139.29 | ↓ -57% |
| Aetna | Neighborhood Network | $149.26 | ↓ -54% |
| Aetna | Home Depot Employer Group | $162.91 | ↓ -49% |
| Aetna | NBR ASO/FI | $165.85 | ↓ -48% |
| UPMC Health Plan | CHIP | $176.40 | ↓ -45% |
| Cigna | New Business ASO | $181.90 | ↓ -43% |
| Bravo | Medicare | $187.25 | ↓ -42% |
| Aetna | EBR FI | $203.30 | ↓ -37% |
| Aetna | EBR ASO | $214.00 | ↓ -33% |
| Cigna | Commercial | $214.00 | ↓ -33% |
| Coventry/First Health | Commercial | $235.40 | ↓ -27% |
| Highmark BCBS of PA | Managed Care - Social Mission | $246.37 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $267.50 | ↓ -17% |
| InterGroup | PPO | $267.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $321.00 | ↑ +0% |
| Highmark BCBS of PA | Managed Care | $329.92 | ↑ +3% |
| Private Health Care Systems | PPO | $401.25 | ↑ +25% |
| American Healthcare Group | Commercial | $428.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $428.00 | ↑ +33% |
| National Provider Network | PPO | $438.70 | ↑ +37% |
| Health Payors Organization | Commercial | $481.50 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $481.50 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $505.99 | ↑ +58% |
| Highmark BCBS of PA | Commercial - Indemnity | $677.62 | ↑ +111% |
Visitor-reported prices
Comments
Debridement (>20 cm) charge pt at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $289.20 | $12.72 – $409.70 |
| UPMC Muncy | Muncy | $259.20 | $12.72 – $345.60 |
| UPMC Northwest | Seneca | $341.40 | $12.72 – $483.65 |
| UPMC Somerset | Somerset | $483.60 | $12.72 – $604.50 |
| UPMC Wellsboro | Wellsboro | $312.80 | $3.51 – $94.55 |
| UPMC Williamsport | Williamsport | $429.00 | $12.72 – $572.00 |