healthcosts.net
Etanercept injection at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,119.00
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.
$1,865.00
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.
$242.82 with Highmark BCBS of PA vs $2,278.11 with United Healthcare Community Plan for Families — 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 | $242.82 | ↓ -78% |
| Aetna | Neighborhood Network | $251.10 | ↓ -78% |
| Aetna | Home Depot Employer Group | $274.05 | ↓ -76% |
| Aetna | NBR ASO/FI | $279.00 | ↓ -75% |
| Cigna | New Business ASO | $306.00 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $312.57 | ↓ -72% |
| UPMC Health Plan | CHIP | $315.00 | ↓ -72% |
| Bravo | Medicare | $315.00 | ↓ -72% |
| Aetna | EBR FI | $342.00 | ↓ -69% |
| Cigna | Commercial | $360.00 | ↓ -68% |
| Aetna | EBR ASO | $360.00 | ↓ -68% |
| Coventry/First Health | Commercial | $396.00 | ↓ -65% |
| UPMC Health Plan | Commercial | $405.00 | ↓ -64% |
| InterGroup | PPO | $450.00 | ↓ -60% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $495.00 | ↓ -56% |
| Cigna Behavioral Health | Commercial | $540.00 | ↓ -52% |
| Private Health Care Systems | PPO | $675.00 | ↓ -40% |
| Highmark BCBS of PA | Managed Care - Social Mission | $690.90 | ↓ -38% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $710.54 | ↓ -37% |
| InterGroup | Approved National Affiliated PPO Business | $720.00 | ↓ -36% |
| American Healthcare Group | Commercial | $720.00 | ↓ -36% |
| National Provider Network | PPO | $738.00 | ↓ -34% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $810.00 | ↓ -28% |
| Health Payors Organization | Commercial | $810.00 | ↓ -28% |
| UPMC Health Plan | Managed Medicare | $901.02 | ↓ -19% |
| Highmark BCBS of PA | Managed Care | $925.32 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $951.65 | ↓ -15% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,109.20 | ↓ -1% |
| Aetna of PA | Medicare | $1,134.92 | ↑ +1% |
| AmeriHealth Caritas | Medicare | $1,167.35 | ↑ +4% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,167.35 | ↑ +4% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,167.35 | ↑ +4% |
| Aetna | Medicare | $1,188.97 | ↑ +6% |
| United Healthcare Community Plan for Families | PA Medicaid | $2,278.11 | ↑ +104% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Etanercept injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,801.80 | $245.13 – $2,080.02 |
| UPMC Presbyterian | Pittsburgh | $1,801.80 | $245.13 – $2,551.70 |
| UPMC St. Margaret | Pittsburgh | $1,801.20 | $245.13 – $2,179.06 |
| UPMC Western Psychiatric | Pittsburgh | $1,801.80 | $240.20 – $2,551.70 |