healthcosts.net
Fem/popl revasc w/stent at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$34,849.20
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.
$58,082.00
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.
$468.11 with UPMC Health Plan vs $99,566.74 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 | $468.11 | ↓ -99% |
| United Healthcare Community Plan for Families | PA Medicaid | $489.38 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $631.09 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $673.39 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $725.22 | ↓ -98% |
| UPMC Health Plan | Managed Medicare | $9,012.77 | ↓ -74% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,095.14 | ↓ -68% |
| Aetna of PA | Medicare | $11,352.46 | ↓ -67% |
| UPMC Health Plan | Commercial | $11,414.37 | ↓ -67% |
| AmeriHealth Caritas | Medicare | $11,676.82 | ↓ -66% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,676.82 | ↓ -66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,676.82 | ↓ -66% |
| Aetna | Medicare | $11,893.06 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $14,892.09 | ↓ -57% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $16,073.32 | ↓ -54% |
| Aetna | Neighborhood Network | $16,204.88 | ↓ -53% |
| Aetna | Home Depot Employer Group | $17,685.97 | ↓ -49% |
| Aetna | NBR ASO/FI | $18,005.42 | ↓ -48% |
| Cigna | New Business ASO | $19,747.88 | ↓ -43% |
| Bravo | Medicare | $20,328.70 | ↓ -42% |
| UPMC Health Plan | CHIP | $20,648.82 | ↓ -41% |
| Aetna | EBR FI | $22,071.16 | ↓ -37% |
| Cigna | Commercial | $23,232.80 | ↓ -33% |
| Aetna | EBR ASO | $23,232.80 | ↓ -33% |
| Coventry/First Health | Commercial | $25,556.08 | ↓ -27% |
| InterGroup | PPO | $29,041.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $34,849.20 | ↑ +0% |
| Highmark BCBS of PA | Managed Care - Social Mission | $36,200.43 | ↑ +4% |
| Private Health Care Systems | PPO | $43,561.50 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $46,465.60 | ↑ +33% |
| American Healthcare Group | Commercial | $46,465.60 | ↑ +33% |
| National Provider Network | PPO | $47,627.24 | ↑ +37% |
| Highmark BCBS of PA | Managed Care | $48,477.65 | ↑ +39% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $52,273.80 | ↑ +50% |
| Health Payors Organization | Commercial | $52,273.80 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $74,347.33 | ↑ +113% |
| Highmark BCBS of PA | Commercial - Indemnity | $99,566.74 | ↑ +186% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Fem/popl revasc w/stent at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $38,983.80 | $10,047.47 – $55,227.05 |
| UPMC Presbyterian | Pittsburgh | $41,308.20 | $468.11 – $58,519.95 |
| UPMC St. Margaret | Pittsburgh | $35,730.60 | $9,334.97 – $50,618.35 |
| UPMC Northwest | Seneca | $34,620.00 | $9,805.28 – $49,045.00 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $7,915.20 | $993.28 – $13,195.02 |