healthcosts.net
Factor viii recomb novoeight at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$3.40
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.
$4.25
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.
$0.97 with UPMC Health Plan vs $4.95 with Highmark BCBS of PA — 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 | $0.97 | ↓ -71% |
| Aetna | Neighborhood Network | $1.12 | ↓ -67% |
| Aetna | Home Depot Employer Group | $1.22 | ↓ -64% |
| Aetna | NBR ASO/FI | $1.24 | ↓ -64% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1.26 | ↓ -63% |
| UPMC Health Plan | Managed Medicare | $1.28 | ↓ -62% |
| Cigna | New Business ASO | $1.36 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $1.39 | ↓ -59% |
| Bravo | Medicare | $1.40 | ↓ -59% |
| Aetna | EBR FI | $1.52 | ↓ -55% |
| Geisinger | Medicaid/CHIP | $1.54 | ↓ -55% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1.54 | ↓ -55% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1.54 | ↓ -55% |
| UPMC Health Plan | CHIP | $1.55 | ↓ -54% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1.58 | ↓ -54% |
| Cigna | Commercial | $1.60 | ↓ -53% |
| Aetna | EBR ASO | $1.60 | ↓ -53% |
| Aetna of PA | Medicare | $1.62 | ↓ -52% |
| AmeriHealth Caritas | Medicare | $1.66 | ↓ -51% |
| Highmark Wholecare (prev Gateway) | Medicare | $1.66 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1.66 | ↓ -51% |
| Aetna | Medicare | $1.69 | ↓ -50% |
| Coventry/First Health | Commercial | $1.76 | ↓ -48% |
| UPMC Health Plan | Commercial | $1.89 | ↓ -44% |
| InterGroup | PPO | $2.00 | ↓ -41% |
| Cigna Behavioral Health | Commercial | $2.40 | ↓ -29% |
| Private Health Care Systems | PPO | $3.00 | ↓ -12% |
| InterGroup | Approved National Affiliated PPO Business | $3.20 | ↓ -6% |
| American Healthcare Group | Commercial | $3.20 | ↓ -6% |
| National Provider Network | PPO | $3.28 | ↓ -4% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $3.60 | ↑ +6% |
| Health Payors Organization | Commercial | $3.60 | ↑ +6% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3.60 | ↑ +6% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3.70 | ↑ +9% |
| Highmark BCBS of PA | Managed Care | $4.82 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity | $4.95 | ↑ +46% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Factor viii recomb novoeight at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3.15 | $0.97 – $4.25 |
| UPMC Presbyterian | Pittsburgh | $3.15 | $0.97 – $4.25 |
| UPMC Western Psychiatric | Pittsburgh | $3.15 | $1.25 – $4.46 |
| UPMC Muncy | Muncy | $3.40 | $0.64 – $3.83 |
| UPMC Somerset | Somerset | $2,592.00 | $1.25 – $1,620.00 |
| UPMC Wellsboro | Wellsboro | $3.40 | $0.77 – $3.83 |
| UPMC Williamsport | Williamsport | $3.40 | $1.08 – $3.60 |