healthcosts.net
Insert cath pleura without image at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$697.20
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.
$1,162.00
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.
$324.20 with Aetna vs $2,927.88 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 |
|---|---|---|---|
| Aetna | Neighborhood Network | $324.20 | ↓ -53% |
| Aetna | Home Depot Employer Group | $353.83 | ↓ -49% |
| Aetna | NBR ASO/FI | $360.22 | ↓ -48% |
| Cigna | New Business ASO | $395.08 | ↓ -43% |
| UPMC Health Plan | CHIP | $406.70 | ↓ -42% |
| Bravo | Medicare | $406.70 | ↓ -42% |
| Aetna | EBR FI | $441.56 | ↓ -37% |
| Cigna | Commercial | $464.80 | ↓ -33% |
| Aetna | EBR ASO | $464.80 | ↓ -33% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $472.66 | ↓ -32% |
| Coventry/First Health | Commercial | $511.28 | ↓ -27% |
| UPMC Health Plan | Commercial | $522.90 | ↓ -25% |
| InterGroup | PPO | $581.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $639.10 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $697.20 | ↑ +0% |
| Private Health Care Systems | PPO | $871.50 | ↑ +25% |
| UPMC Work Partners | Workers Comp | $903.89 | ↑ +30% |
| InterGroup | Approved National Affiliated PPO Business | $929.60 | ↑ +33% |
| American Healthcare Group | Commercial | $929.60 | ↑ +33% |
| National Provider Network | PPO | $952.84 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,045.80 | ↑ +50% |
| Health Payors Organization | Commercial | $1,045.80 | ↑ +50% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,064.52 | ↑ +53% |
| Highmark BCBS of PA | Managed Care | $1,425.54 | ↑ +104% |
| UPMC Health Plan | Managed Medicare | $1,507.61 | ↑ +116% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,855.93 | ↑ +166% |
| Aetna of PA | Medicare | $1,898.98 | ↑ +172% |
| AmeriHealth Caritas | Medicare | $1,953.23 | ↑ +180% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,953.23 | ↑ +180% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,953.23 | ↑ +180% |
| Aetna | Medicare | $1,989.40 | ↑ +185% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,186.27 | ↑ +214% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,927.88 | ↑ +320% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Insert cath pleura without image at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $833.40 | $472.26 – $1,989.40 |
| UPMC Presbyterian | Pittsburgh | $2,890.80 | $477.16 – $4,095.30 |
| UPMC St. Margaret | Pittsburgh | $2,585.40 | $477.16 – $3,662.65 |
| UPMC Muncy | Muncy | $2,977.80 | $744.45 – $3,970.40 |
| UPMC Northwest | Seneca | $2,829.00 | $791.18 – $4,007.75 |
| UPMC Wellsboro | Wellsboro | $1,020.00 | $229.50 – $1,147.50 |
| UPMC Williamsport | Williamsport | $2,977.80 | $791.18 – $3,970.40 |