healthcosts.net
Insertion subcutaneous cardiac rhythm monitor at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$8,470.20
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.
$14,117.00
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.
$3,012.17 with Highmark BCBS of PA vs $18,658.97 with Highmark BCBS of PA — 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 | $3,012.17 | ↓ -64% |
| UPMC Health Plan | Commercial | $3,910.08 | ↓ -54% |
| Aetna | Neighborhood Network | $3,938.64 | ↓ -54% |
| Aetna | Home Depot Employer Group | $4,298.63 | ↓ -49% |
| Aetna | NBR ASO/FI | $4,376.27 | ↓ -48% |
| Cigna | New Business ASO | $4,799.78 | ↓ -43% |
| Bravo | Medicare | $4,940.95 | ↓ -42% |
| Aetna | EBR FI | $5,364.46 | ↓ -37% |
| Cigna | Commercial | $5,646.80 | ↓ -33% |
| Aetna | EBR ASO | $5,646.80 | ↓ -33% |
| Coventry/First Health | Commercial | $6,211.48 | ↓ -27% |
| UPMC Health Plan | Managed Medicare | $6,577.23 | ↓ -22% |
| Highmark BCBS of PA | Managed Care - Social Mission | $6,784.02 | ↓ -20% |
| UPMC Work Partners | Workers Comp | $6,850.42 | ↓ -19% |
| InterGroup | PPO | $7,058.50 | ↓ -17% |
| UPMC Health Plan | CHIP | $7,073.42 | ↓ -16% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $7,764.35 | ↓ -8% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $8,096.87 | ↓ -4% |
| Aetna of PA | Medicare | $8,284.66 | ↓ -2% |
| Cigna Behavioral Health | Commercial | $8,470.20 | ↑ +0% |
| AmeriHealth Caritas | Medicare | $8,521.36 | ↑ +1% |
| Highmark Wholecare (prev Gateway) | Medicare | $8,521.36 | ↑ +1% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $8,521.36 | ↑ +1% |
| Aetna | Medicare | $8,679.17 | ↑ +2% |
| Highmark BCBS of PA | Managed Care | $9,084.79 | ↑ +7% |
| Private Health Care Systems | PPO | $10,587.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $11,293.60 | ↑ +33% |
| American Healthcare Group | Commercial | $11,293.60 | ↑ +33% |
| National Provider Network | PPO | $11,575.94 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $12,705.30 | ↑ +50% |
| Health Payors Organization | Commercial | $12,705.30 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $13,932.81 | ↑ +64% |
| Highmark BCBS of PA | Commercial - Indemnity | $18,658.97 | ↑ +120% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Insertion subcutaneous cardiac rhythm monitor at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $8,850.60 | $3,040.85 – $12,538.35 |
| UPMC Presbyterian | Pittsburgh | $12,462.00 | $931.20 – $17,654.50 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $2,804.40 | $993.28 – $8,520.57 |
| UPMC Northwest | Seneca | not published | $5,097.41 – $8,521.36 |