healthcosts.net
Insert pm/icd lead dual at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$6,057.00
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.
$10,095.00
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.
$700.58 with Highmark BCBS of PA vs $12,194.22 with UPMC Health Plan — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $700.58 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $1,034.69 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,577.85 | ↓ -74% |
| Highmark BCBS of PA | Managed Care | $2,112.98 | ↓ -65% |
| Aetna | Neighborhood Network | $2,816.51 | ↓ -53% |
| Aetna | Home Depot Employer Group | $3,073.93 | ↓ -49% |
| Aetna | NBR ASO/FI | $3,129.45 | ↓ -48% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,240.55 | ↓ -46% |
| Cigna | New Business ASO | $3,432.30 | ↓ -43% |
| Bravo | Medicare | $3,533.25 | ↓ -42% |
| Aetna | EBR FI | $3,836.10 | ↓ -37% |
| Cigna | Commercial | $4,038.00 | ↓ -33% |
| Aetna | EBR ASO | $4,038.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,339.78 | ↓ -28% |
| Coventry/First Health | Commercial | $4,441.80 | ↓ -27% |
| InterGroup | PPO | $5,047.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $5,552.25 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $6,057.00 | ↑ +0% |
| UPMC Health Plan | Managed Medicare | $6,577.23 | ↑ +9% |
| Private Health Care Systems | PPO | $7,571.25 | ↑ +25% |
| UPMC Health Plan | Commercial | $7,661.24 | ↑ +26% |
| InterGroup | Approved National Affiliated PPO Business | $8,076.00 | ↑ +33% |
| American Healthcare Group | Commercial | $8,076.00 | ↑ +33% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $8,096.87 | ↑ +34% |
| National Provider Network | PPO | $8,277.90 | ↑ +37% |
| Aetna of PA | Medicare | $8,284.66 | ↑ +37% |
| AmeriHealth Caritas | Medicare | $8,521.36 | ↑ +41% |
| Highmark Wholecare (prev Gateway) | Medicare | $8,521.36 | ↑ +41% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $8,521.36 | ↑ +41% |
| Aetna | Medicare | $8,679.17 | ↑ +43% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $9,085.50 | ↑ +50% |
| Health Payors Organization | Commercial | $9,085.50 | ↑ +50% |
| UPMC Health Plan | CHIP | $12,194.22 | ↑ +101% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Insert pm/icd lead dual at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $9,288.60 | $707.25 – $13,158.85 |
| UPMC Presbyterian | Pittsburgh | $9,305.40 | $707.25 – $13,182.65 |
| UPMC Somerset | Somerset | $11,583.60 | $693.50 – $14,479.50 |
| UPMC Williamsport | Williamsport | $5,231.40 | $993.28 – $8,520.57 |