healthcosts.net
Electrophysiology evaluation at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,368.00
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.
$2,280.00
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.
$476.95 with Highmark BCBS of PA vs $2,704.69 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $476.95 | ↓ -65% |
| Aetna | Neighborhood Network | $636.12 | ↓ -54% |
| Aetna | Home Depot Employer Group | $694.26 | ↓ -49% |
| Aetna | NBR ASO/FI | $706.80 | ↓ -48% |
| Cigna | New Business ASO | $775.20 | ↓ -43% |
| Bravo | Medicare | $798.00 | ↓ -42% |
| Aetna | EBR FI | $866.40 | ↓ -37% |
| Cigna | Commercial | $912.00 | ↓ -33% |
| Aetna | EBR ASO | $912.00 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $964.80 | ↓ -29% |
| Coventry/First Health | Commercial | $1,003.20 | ↓ -27% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,074.19 | ↓ -21% |
| InterGroup | PPO | $1,140.00 | ↓ -17% |
| UPMC Health Plan | Commercial | $1,174.13 | ↓ -14% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,187.71 | ↓ -13% |
| Aetna of PA | Medicare | $1,215.26 | ↓ -11% |
| AmeriHealth Caritas | Medicare | $1,249.98 | ↓ -9% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,249.98 | ↓ -9% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,249.98 | ↓ -9% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,254.00 | ↓ -8% |
| Aetna | Medicare | $1,273.13 | ↓ -7% |
| UPMC Work Partners | Workers Comp | $1,319.76 | ↓ -4% |
| Cigna Behavioral Health | Commercial | $1,368.00 | ↑ +0% |
| Highmark BCBS of PA | Managed Care | $1,438.49 | ↑ +5% |
| UPMC Health Plan | CHIP | $1,486.91 | ↑ +9% |
| Private Health Care Systems | PPO | $1,710.00 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $1,824.00 | ↑ +33% |
| American Healthcare Group | Commercial | $1,824.00 | ↑ +33% |
| National Provider Network | PPO | $1,869.60 | ↑ +37% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,019.57 | ↑ +48% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $2,052.00 | ↑ +50% |
| Health Payors Organization | Commercial | $2,052.00 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,704.69 | ↑ +98% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Electrophysiology evaluation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,735.80 | $481.49 – $2,459.05 |
| UPMC Presbyterian | Pittsburgh | $2,535.60 | $481.49 – $3,592.10 |
| UPMC Somerset | Somerset | $3,064.20 | $472.13 – $3,830.25 |