healthcosts.net
Factor viii at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$136.20
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.
?
What you pay up front if you don't use insurance.
$227.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$14.30 with UPMC Health Plan vs $204.30 with Health Payors Organization — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $14.30 | ↓ -90% |
| UPMC Health Plan | Managed Medicare | $14.92 | ↓ -89% |
| United Healthcare Community Plan for Families | PA Medicaid | $14.95 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $17.69 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $17.90 | ↓ -87% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $18.37 | ↓ -87% |
| Aetna of PA | Medicare | $18.80 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $19.28 | ↓ -86% |
| AmeriHealth Caritas | Medicare | $19.33 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicare | $19.33 | ↓ -86% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $19.33 | ↓ -86% |
| Aetna | Medicare | $19.69 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $20.57 | ↓ -85% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $22.15 | ↓ -84% |
| UPMC Health Plan | Commercial | $29.90 | ↓ -78% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $34.59 | ↓ -75% |
| Highmark BCBS of PA | Managed Care - Social Mission | $52.24 | ↓ -62% |
| Aetna | Neighborhood Network | $63.33 | ↓ -54% |
| Aetna | Home Depot Employer Group | $69.12 | ↓ -49% |
| Highmark BCBS of PA | Managed Care | $69.96 | ↓ -49% |
| Aetna | NBR ASO/FI | $70.37 | ↓ -48% |
| Cigna | New Business ASO | $77.18 | ↓ -43% |
| Bravo | Medicare | $79.45 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $82.57 | ↓ -39% |
| Aetna | EBR FI | $86.26 | ↓ -37% |
| Cigna | Commercial | $90.80 | ↓ -33% |
| Aetna | EBR ASO | $90.80 | ↓ -33% |
| Coventry/First Health | Commercial | $99.88 | ↓ -27% |
| UPMC Health Plan | CHIP | $108.36 | ↓ -20% |
| Highmark BCBS of PA | Commercial - Indemnity | $110.58 | ↓ -19% |
| InterGroup | PPO | $113.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $136.20 | ↑ +0% |
| Private Health Care Systems | PPO | $170.25 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $181.60 | ↑ +33% |
| American Healthcare Group | Commercial | $181.60 | ↑ +33% |
| National Provider Network | PPO | $186.14 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $204.30 | ↑ +50% |
| Health Payors Organization | Commercial | $204.30 | ↑ +50% |
Visitor-reported prices
Comments
Factor viii at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $213.00 | $14.30 – $301.75 |
| UPMC St. Margaret | Pittsburgh | $222.60 | $14.30 – $315.35 |
| UPMC Presbyterian | Pittsburgh | $2,282.40 | $13.00 – $3,233.40 |
| UPMC Muncy | Muncy | $289.80 | $14.30 – $386.40 |
| UPMC Northwest | Seneca | $112.80 | $14.30 – $159.80 |
| UPMC Somerset | Somerset | $91.20 | $14.30 – $61.50 |
| UPMC Wellsboro | Wellsboro | $289.60 | $13.00 – $325.80 |
| UPMC Williamsport | Williamsport | $239.40 | $14.30 – $304.00 |