healthcosts.net
Embo or occlude vascular arterial s&i at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$12,721.80
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.
$21,203.00
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.
$449.83 with UPMC Health Plan vs $33,002.92 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 | $449.83 | ↓ -96% |
| United Healthcare Community Plan for Families | PA Medicaid | $470.28 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $606.46 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $647.11 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $696.92 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $5,327.75 | ↓ -58% |
| Aetna | Neighborhood Network | $5,915.64 | ↓ -53% |
| Aetna | Home Depot Employer Group | $6,456.31 | ↓ -49% |
| Aetna | NBR ASO/FI | $6,572.93 | ↓ -48% |
| Cigna | New Business ASO | $7,209.02 | ↓ -43% |
| UPMC Health Plan | CHIP | $7,421.05 | ↓ -42% |
| Bravo | Medicare | $7,421.05 | ↓ -42% |
| Aetna | EBR FI | $8,057.14 | ↓ -37% |
| Cigna | Commercial | $8,481.20 | ↓ -33% |
| Aetna | EBR ASO | $8,481.20 | ↓ -33% |
| Coventry/First Health | Commercial | $9,329.32 | ↓ -27% |
| UPMC Health Plan | Commercial | $9,541.35 | ↓ -25% |
| InterGroup | PPO | $10,601.50 | ↓ -17% |
| UPMC Work Partners | Workers Comp | $11,759.42 | ↓ -8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $11,999.19 | ↓ -6% |
| Cigna Behavioral Health | Commercial | $12,721.80 | ↑ +0% |
| UPMC Health Plan | Managed Medicare | $14,270.88 | ↑ +12% |
| Private Health Care Systems | PPO | $15,902.25 | ↑ +25% |
| Highmark BCBS of PA | Managed Care | $16,068.66 | ↑ +26% |
| InterGroup | Approved National Affiliated PPO Business | $16,962.40 | ↑ +33% |
| American Healthcare Group | Commercial | $16,962.40 | ↑ +33% |
| National Provider Network | PPO | $17,386.46 | ↑ +37% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $17,568.11 | ↑ +38% |
| Aetna of PA | Medicare | $17,975.56 | ↑ +41% |
| AmeriHealth Caritas | Medicare | $18,489.15 | ↑ +45% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,489.15 | ↑ +45% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,489.15 | ↑ +45% |
| Aetna | Medicare | $18,831.54 | ↑ +48% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $19,082.70 | ↑ +50% |
| Health Payors Organization | Commercial | $19,082.70 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $24,643.56 | ↑ +94% |
| Highmark BCBS of PA | Commercial - Indemnity | $33,002.92 | ↑ +159% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Embo or occlude vascular arterial s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $13,485.60 | $449.83 – $19,104.60 |
| UPMC Presbyterian | Pittsburgh | $39,561.60 | $449.83 – $56,045.60 |
| UPMC St. Margaret | Pittsburgh | $12,721.80 | $449.83 – $18,022.55 |
| UPMC Somerset | Somerset | $25,921.80 | $449.83 – $32,402.25 |
| UPMC Williamsport | Williamsport | $6,596.40 | $449.83 – $10,146.49 |