healthcosts.net
Ins/rpl pm gen exist dual lead at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$10,852.20
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.
$18,087.00
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.
$681.00 with Private Health Care Systems vs $16,278.30 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 |
|---|---|---|---|
| Private Health Care Systems | PPO | $681.00 | ↓ -94% |
| UPMC Work Partners | Workers Comp | $1,231.98 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,631.43 | ↓ -85% |
| UPMC Health Plan | Commercial | $3,235.25 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,674.32 | ↓ -66% |
| Highmark BCBS of PA | Managed Care | $4,920.45 | ↓ -55% |
| Aetna | Neighborhood Network | $5,046.27 | ↓ -54% |
| UPMC Health Plan | CHIP | $5,149.48 | ↓ -53% |
| Aetna | Home Depot Employer Group | $5,507.49 | ↓ -49% |
| Aetna | NBR ASO/FI | $5,606.97 | ↓ -48% |
| Cigna | New Business ASO | $6,149.58 | ↓ -43% |
| Bravo | Medicare | $6,330.45 | ↓ -42% |
| Aetna | EBR FI | $6,873.06 | ↓ -37% |
| Cigna | Commercial | $7,234.80 | ↓ -33% |
| Aetna | EBR ASO | $7,234.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7,546.20 | ↓ -30% |
| Coventry/First Health | Commercial | $7,958.28 | ↓ -27% |
| UPMC Health Plan | Managed Medicare | $8,317.19 | ↓ -23% |
| InterGroup | PPO | $9,043.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $9,947.85 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Indemnity | $10,105.96 | ↓ -7% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10,238.85 | ↓ -6% |
| Aetna of PA | Medicare | $10,476.31 | ↓ -3% |
| AmeriHealth Caritas | Medicare | $10,775.64 | ↓ -1% |
| Highmark Wholecare (prev Gateway) | Medicare | $10,775.64 | ↓ -1% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,775.64 | ↓ -1% |
| Cigna Behavioral Health | Commercial | $10,852.20 | ↑ +0% |
| Aetna | Medicare | $10,975.18 | ↑ +1% |
| InterGroup | Approved National Affiliated PPO Business | $14,469.60 | ↑ +33% |
| American Healthcare Group | Commercial | $14,469.60 | ↑ +33% |
| National Provider Network | PPO | $14,831.34 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $16,278.30 | ↑ +50% |
| Health Payors Organization | Commercial | $16,278.30 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm gen exist dual lead at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $18,634.20 | $931.20 – $26,398.45 |
| UPMC Somerset | Somerset | $15,540.60 | $892.40 – $19,425.75 |
| UPMC Williamsport | Williamsport | $3,922.80 | $993.28 – $10,774.64 |