healthcosts.net
Inj mogamulizumab-kpkc, 1 mg at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$691.20
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.
$864.00
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.
$120.93 with Highmark BCBS of PA vs $777.60 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $120.93 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $156.90 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $207.15 | ↓ -70% |
| Aetna | Neighborhood Network | $241.06 | ↓ -65% |
| Geisinger | Medicaid/CHIP | $248.50 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $248.50 | ↓ -64% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $248.50 | ↓ -64% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $255.01 | ↓ -63% |
| Aetna of PA | Medicare | $260.93 | ↓ -62% |
| Aetna | Home Depot Employer Group | $263.09 | ↓ -62% |
| Aetna | NBR ASO/FI | $267.84 | ↓ -61% |
| AmeriHealth Caritas | Medicare | $268.38 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $268.38 | ↓ -61% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $268.38 | ↓ -61% |
| UPMC Health Plan | CHIP | $271.72 | ↓ -61% |
| Aetna | Medicare | $273.35 | ↓ -60% |
| Cigna | New Business ASO | $293.76 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $300.07 | ↓ -57% |
| Bravo | Medicare | $302.40 | ↓ -56% |
| UPMC Health Plan | Commercial | $305.65 | ↓ -56% |
| Aetna | EBR FI | $328.32 | ↓ -53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $344.10 | ↓ -50% |
| Cigna | Commercial | $345.60 | ↓ -50% |
| Aetna | EBR ASO | $345.60 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $353.88 | ↓ -49% |
| Coventry/First Health | Commercial | $380.16 | ↓ -45% |
| InterGroup | PPO | $432.00 | ↓ -38% |
| Highmark BCBS of PA | Managed Care | $460.85 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $473.97 | ↓ -31% |
| Cigna Behavioral Health | Commercial | $518.40 | ↓ -25% |
| Private Health Care Systems | PPO | $648.00 | ↓ -6% |
| InterGroup | Approved National Affiliated PPO Business | $691.20 | ↑ +0% |
| American Healthcare Group | Commercial | $691.20 | ↑ +0% |
| National Provider Network | PPO | $708.48 | ↑ +3% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $777.60 | ↑ +13% |
| Health Payors Organization | Commercial | $777.60 | ↑ +13% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Inj mogamulizumab-kpkc, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $691.20 | $122.09 – $724.20 |
| UPMC St. Margaret | Pittsburgh | $691.20 | $122.09 – $734.40 |
| UPMC Western Psychiatric | Pittsburgh | $691.20 | $119.63 – $979.20 |
| UPMC Muncy | Muncy | $558.40 | $104.70 – $628.20 |
| UPMC Northwest | Seneca | $691.20 | $156.90 – $734.40 |
| UPMC Somerset | Somerset | $540.60 | $119.71 – $675.75 |
| UPMC Wellsboro | Wellsboro | $558.40 | $125.64 – $628.20 |
| UPMC Williamsport | Williamsport | $558.40 | $189.30 – $628.20 |