healthcosts.net
Ercp stent exchange w/dilate at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$4,282.20
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.
$7,137.00
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.
$374.99 with Highmark BCBS of PA vs $6,423.30 with Health Payors Organization — 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 | $374.99 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $780.01 | ↓ -82% |
| Highmark BCBS of PA | Managed Care - Social Mission | $844.56 | ↓ -80% |
| Highmark BCBS of PA | Managed Care | $1,130.99 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,587.86 | ↓ -63% |
| Aetna | Neighborhood Network | $1,991.22 | ↓ -54% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,126.52 | ↓ -50% |
| Aetna | Home Depot Employer Group | $2,173.22 | ↓ -49% |
| Aetna | NBR ASO/FI | $2,212.47 | ↓ -48% |
| Cigna | New Business ASO | $2,426.58 | ↓ -43% |
| Bravo | Medicare | $2,497.95 | ↓ -42% |
| Aetna | EBR FI | $2,712.06 | ↓ -37% |
| UPMC Health Plan | Commercial | $2,782.39 | ↓ -35% |
| Cigna | Commercial | $2,854.80 | ↓ -33% |
| Aetna | EBR ASO | $2,854.80 | ↓ -33% |
| Coventry/First Health | Commercial | $3,140.28 | ↓ -27% |
| InterGroup | PPO | $3,568.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,925.35 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $4,282.20 | ↑ +0% |
| UPMC Health Plan | Managed Medicare | $4,730.92 | ↑ +10% |
| UPMC Health Plan | CHIP | $5,033.39 | ↑ +18% |
| Private Health Care Systems | PPO | $5,352.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $5,709.60 | ↑ +33% |
| American Healthcare Group | Commercial | $5,709.60 | ↑ +33% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $5,823.98 | ↑ +36% |
| National Provider Network | PPO | $5,852.34 | ↑ +37% |
| Aetna of PA | Medicare | $5,959.05 | ↑ +39% |
| AmeriHealth Caritas | Medicare | $6,129.31 | ↑ +43% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,129.31 | ↑ +43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $6,129.31 | ↑ +43% |
| Aetna | Medicare | $6,242.82 | ↑ +46% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $6,423.30 | ↑ +50% |
| Health Payors Organization | Commercial | $6,423.30 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ercp stent exchange w/dilate at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,784.00 | $378.57 – $6,242.82 |
| UPMC Presbyterian | Pittsburgh | $12,039.00 | $378.57 – $17,055.25 |
| UPMC St. Margaret | Pittsburgh | $7,024.80 | $378.57 – $9,951.80 |
| UPMC Wellsboro | Wellsboro | $7,896.80 | $714.16 – $8,883.90 |
| UPMC Williamsport | Williamsport | $6,529.80 | $714.16 – $8,706.40 |