healthcosts.net
Ins picad w subq port 5yr> at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$5,418.00
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.
$9,030.00
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.
$681.00 with Private Health Care Systems vs $8,127.00 with Health Payors Organization — 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 |
|---|---|---|---|
| Private Health Care Systems | PPO | $681.00 | ↓ -87% |
| UPMC Health Plan | Commercial | $699.72 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $895.03 | ↓ -83% |
| UPMC Health Plan | CHIP | $1,113.73 | ↓ -79% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,015.79 | ↓ -63% |
| UPMC Health Plan | Managed Medicare | $2,501.43 | ↓ -54% |
| Aetna | Neighborhood Network | $2,519.37 | ↓ -54% |
| Highmark BCBS of PA | Managed Care | $2,699.44 | ↓ -50% |
| Aetna | Home Depot Employer Group | $2,749.64 | ↓ -49% |
| Aetna | NBR ASO/FI | $2,799.30 | ↓ -48% |
| Cigna | New Business ASO | $3,070.20 | ↓ -43% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,079.38 | ↓ -43% |
| Aetna of PA | Medicare | $3,150.80 | ↓ -42% |
| Bravo | Medicare | $3,160.50 | ↓ -42% |
| UPMC Work Partners | Workers Comp | $3,201.16 | ↓ -41% |
| AmeriHealth Caritas | Medicare | $3,240.82 | ↓ -40% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,240.82 | ↓ -40% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,240.82 | ↓ -40% |
| Aetna | Medicare | $3,300.84 | ↓ -39% |
| Aetna | EBR FI | $3,431.40 | ↓ -37% |
| Cigna | Commercial | $3,612.00 | ↓ -33% |
| Aetna | EBR ASO | $3,612.00 | ↓ -33% |
| Coventry/First Health | Commercial | $3,973.20 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,139.97 | ↓ -24% |
| InterGroup | PPO | $4,515.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4,966.50 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $5,418.00 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,544.30 | ↑ +2% |
| InterGroup | Approved National Affiliated PPO Business | $7,224.00 | ↑ +33% |
| American Healthcare Group | Commercial | $7,224.00 | ↑ +33% |
| National Provider Network | PPO | $7,404.60 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $8,127.00 | ↑ +50% |
| Health Payors Organization | Commercial | $8,127.00 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins picad w subq port 5yr> at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,961.00 | $503.41 – $4,194.75 |
| UPMC Presbyterian | Pittsburgh | $5,529.60 | $423.71 – $7,833.60 |
| UPMC St. Margaret | Pittsburgh | $4,228.20 | $499.85 – $5,989.95 |
| UPMC Muncy | Muncy | $1,705.80 | $426.45 – $2,755.22 |
| UPMC Somerset | Somerset | $4,201.80 | $885.98 – $5,252.25 |
| UPMC Wellsboro | Wellsboro | $2,063.20 | $464.22 – $2,755.22 |
| UPMC Williamsport | Williamsport | $1,624.80 | $993.28 – $3,240.52 |
| UPMC Northwest | Seneca | not published | $526.12 – $3,240.82 |