healthcosts.net
Inj cntr knee arthro incl ct/mri at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,513.80
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.
$2,523.00
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.
$84.91 with Highmark BCBS of PA vs $2,270.70 with Multiplan — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $84.91 | ↓ -94% |
| Premier Comp Solutions | Worker's Comp | $176.57 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $189.81 | ↓ -87% |
| Highmark BCBS of PA | Managed Care - Social Mission | $191.23 | ↓ -87% |
| Highmark BCBS of PA | Managed Care | $256.09 | ↓ -83% |
| UPMC Health Plan | Commercial | $322.59 | ↓ -79% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $392.75 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Indemnity | $525.98 | ↓ -65% |
| UPMC Health Plan | CHIP | $583.58 | ↓ -61% |
| Aetna | Medicare | $630.75 | ↓ -58% |
| Aetna | Neighborhood Network | $703.92 | ↓ -53% |
| Aetna | Home Depot Employer Group | $768.25 | ↓ -49% |
| Aetna | NBR ASO/FI | $782.13 | ↓ -48% |
| Cigna | New Business ASO | $857.82 | ↓ -43% |
| Bravo | Medicare | $883.05 | ↓ -42% |
| Aetna | EBR FI | $958.74 | ↓ -37% |
| Aetna | EBR ASO | $1,009.20 | ↓ -33% |
| Cigna | Commercial | $1,009.20 | ↓ -33% |
| Coventry/First Health | Commercial | $1,110.12 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,261.50 | ↓ -17% |
| InterGroup | PPO | $1,261.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,387.65 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $1,513.80 | ↑ +0% |
| Private Health Care Systems | PPO | $1,892.25 | ↑ +25% |
| American Healthcare Group | Commercial | $2,018.40 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $2,018.40 | ↑ +33% |
| National Provider Network | PPO | $2,068.86 | ↑ +37% |
| Health Payors Organization | Commercial | $2,270.70 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $2,270.70 | ↑ +50% |
Visitor-reported prices
Comments
Inj cntr knee arthro incl ct/mri at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $286.80 | $85.72 – $406.30 |
| UPMC Presbyterian | Pittsburgh | $345.60 | $39.90 – $489.60 |
| UPMC St. Margaret | Pittsburgh | $590.40 | $85.72 – $836.40 |
| UPMC Muncy | Muncy | $969.00 | $42.56 – $1,292.00 |
| UPMC Northwest | Seneca | $162.00 | $67.50 – $420.55 |
| UPMC Somerset | Somerset | $186.60 | $38.24 – $349.54 |
| UPMC Wellsboro | Wellsboro | $1,172.00 | $42.56 – $1,318.50 |
| UPMC Williamsport | Williamsport | $969.00 | $42.56 – $1,292.00 |