healthcosts.net
Dornhoffer fixed part w/window at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$53,356.20
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.
$88,927.00
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.
$403.44 with Highmark Wholecare (prev Gateway) vs $68,394.31 with UPMC Health Plan — 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 Wholecare (prev Gateway) | Medicaid | $403.44 | ↓ -99% |
| Aetna | Medicare | $420.25 | ↓ -99% |
| Aetna | Neighborhood Network | $469.00 | ↓ -99% |
| Aetna | Home Depot Employer Group | $511.86 | ↓ -99% |
| Aetna | NBR ASO/FI | $521.11 | ↓ -99% |
| Cigna | New Business ASO | $571.54 | ↓ -99% |
| Aetna | EBR FI | $638.78 | ↓ -99% |
| Aetna | EBR ASO | $672.40 | ↓ -99% |
| Cigna | Commercial | $672.40 | ↓ -99% |
| Coventry/First Health | Commercial | $739.64 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $840.50 | ↓ -98% |
| InterGroup | PPO | $840.50 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $924.55 | ↓ -98% |
| Cigna Behavioral Health | Commercial | $1,008.60 | ↓ -98% |
| Private Health Care Systems | PPO | $1,260.75 | ↓ -98% |
| American Healthcare Group | Commercial | $1,344.80 | ↓ -97% |
| InterGroup | Approved National Affiliated PPO Business | $1,344.80 | ↓ -97% |
| National Provider Network | PPO | $1,378.42 | ↓ -97% |
| Health Payors Organization | Commercial | $1,512.90 | ↓ -97% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,512.90 | ↓ -97% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $21,735.73 | ↓ -59% |
| Highmark BCBS of PA | Managed Care - Social Mission | $32,825.77 | ↓ -38% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $33,422.13 | ↓ -37% |
| Highmark BCBS of PA | Managed Care | $43,957.90 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Indemnity | $44,755.40 | ↓ -16% |
| UPMC Health Plan | Commercial | $54,007.08 | ↑ +1% |
| UPMC Health Plan | CHIP | $68,394.31 | ↑ +28% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Bravo | Medicare | not published by hospital | — |
Visitor-reported prices
Comments
Dornhoffer fixed part w/window at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $29,415.60 | $10,785.72 – $99,248.70 |
| UPMC Presbyterian | Pittsburgh | $54,599.40 | $0.96 – $110,581.39 |
| UPMC Muncy | Muncy | $36,517.20 | $9,129.30 – $54,775.80 |
| UPMC Wellsboro | Wellsboro | $44,163.20 | $9,936.72 – $49,683.60 |