healthcosts.net
Echo stress at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$3,820.20
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.
?
What you pay up front if you don't use insurance.
$6,367.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$84.15 with UPMC Health Plan vs $5,730.30 with Health Payors Organization — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $84.15 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $87.97 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $113.45 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $121.05 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $130.37 | ↓ -97% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $163.89 | ↓ -96% |
| Highmark BCBS of PA | Managed Care - Social Mission | $369.11 | ↓ -90% |
| UPMC Health Plan | Commercial | $406.82 | ↓ -89% |
| UPMC Health Plan | Managed Medicare | $435.76 | ↓ -89% |
| Highmark BCBS of PA | Managed Care | $494.30 | ↓ -87% |
| UPMC Health Plan | CHIP | $515.20 | ↓ -87% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $536.44 | ↓ -86% |
| Aetna of PA | Medicare | $548.88 | ↓ -86% |
| AmeriHealth Caritas | Medicare | $564.56 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $564.56 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $564.56 | ↓ -85% |
| Aetna | Medicare | $575.01 | ↓ -85% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $693.97 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Indemnity | $929.39 | ↓ -76% |
| UPMC Work Partners | Workers Comp | $962.59 | ↓ -75% |
| Aetna | Neighborhood Network | $1,776.39 | ↓ -54% |
| Aetna | Home Depot Employer Group | $1,938.75 | ↓ -49% |
| Aetna | NBR ASO/FI | $1,973.77 | ↓ -48% |
| Cigna | New Business ASO | $2,164.78 | ↓ -43% |
| Bravo | Medicare | $2,228.45 | ↓ -42% |
| Aetna | EBR FI | $2,419.46 | ↓ -37% |
| Cigna | Commercial | $2,546.80 | ↓ -33% |
| Aetna | EBR ASO | $2,546.80 | ↓ -33% |
| Coventry/First Health | Commercial | $2,801.48 | ↓ -27% |
| InterGroup | PPO | $3,183.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $3,820.20 | ↑ +0% |
| Private Health Care Systems | PPO | $4,775.25 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $5,093.60 | ↑ +33% |
| American Healthcare Group | Commercial | $5,093.60 | ↑ +33% |
| National Provider Network | PPO | $5,220.94 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $5,730.30 | ↑ +50% |
| Health Payors Organization | Commercial | $5,730.30 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Echo stress at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,044.60 | $84.15 – $1,479.85 |
| UPMC Presbyterian | Pittsburgh | $5,167.80 | $55.80 – $7,321.05 |
| UPMC Muncy | Muncy | $873.00 | $59.52 – $1,164.00 |
| UPMC Northwest | Seneca | $626.40 | $84.15 – $937.61 |
| UPMC Somerset | Somerset | $1,737.60 | $53.48 – $933.78 |
| UPMC Wellsboro | Wellsboro | $1,056.00 | $59.52 – $1,109.70 |
| UPMC Williamsport | Williamsport | $816.00 | $59.52 – $1,088.00 |