healthcosts.net
Eeg during surgery at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,561.20
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.
$2,602.00
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.
$119.52 with Highmark BCBS of PA vs $2,341.80 with Multiplan — 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 | $119.52 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $131.28 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $137.25 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $177.00 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $188.86 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $203.40 | ↓ -87% |
| Highmark BCBS of PA | Managed Care - Social Mission | $269.19 | ↓ -83% |
| UPMC Health Plan | Commercial | $284.11 | ↓ -82% |
| UPMC Health Plan | CHIP | $359.80 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $360.48 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $390.39 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $506.09 | ↓ -68% |
| Aetna | Medicare | $650.50 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity | $677.78 | ↓ -57% |
| Aetna | Neighborhood Network | $725.96 | ↓ -53% |
| Aetna | Home Depot Employer Group | $792.31 | ↓ -49% |
| Aetna | NBR ASO/FI | $806.62 | ↓ -48% |
| Cigna | New Business ASO | $884.68 | ↓ -43% |
| Bravo | Medicare | $910.70 | ↓ -42% |
| Aetna | EBR FI | $988.76 | ↓ -37% |
| Aetna | EBR ASO | $1,040.80 | ↓ -33% |
| Cigna | Commercial | $1,040.80 | ↓ -33% |
| Coventry/First Health | Commercial | $1,144.88 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,301.00 | ↓ -17% |
| InterGroup | PPO | $1,301.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $1,561.20 | ↑ +0% |
| Private Health Care Systems | PPO | $1,951.50 | ↑ +25% |
| American Healthcare Group | Commercial | $2,081.60 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $2,081.60 | ↑ +33% |
| National Provider Network | PPO | $2,133.64 | ↑ +37% |
| Health Payors Organization | Commercial | $2,341.80 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $2,341.80 | ↑ +50% |
Visitor-reported prices
Comments
Eeg during surgery at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $643.80 | $120.66 – $912.05 |
| UPMC Presbyterian | Pittsburgh | $1,827.60 | $87.04 – $2,589.10 |
| UPMC St. Margaret | Pittsburgh | $1,813.80 | $120.66 – $2,569.55 |
| UPMC Northwest | Seneca | $604.80 | $131.28 – $856.80 |
| UPMC Somerset | Somerset | $363.60 | $83.41 – $454.50 |
| UPMC Williamsport | Williamsport | $546.60 | $92.84 – $728.80 |