healthcosts.net
Lip surgery procedure at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$71.40
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.
$119.00
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.
$18.59 with Highmark BCBS of PA vs $243.53 with Aetna — 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 | $18.59 | ↓ -74% |
| Aetna | Neighborhood Network | $33.20 | ↓ -54% |
| Aetna | Home Depot Employer Group | $36.24 | ↓ -49% |
| Aetna | NBR ASO/FI | $36.89 | ↓ -48% |
| UPMC Health Plan | Commercial | $36.96 | ↓ -48% |
| Cigna | New Business ASO | $40.46 | ↓ -43% |
| Bravo | Medicare | $41.65 | ↓ -42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $41.86 | ↓ -41% |
| Aetna | EBR FI | $45.22 | ↓ -37% |
| Cigna | Commercial | $47.60 | ↓ -33% |
| Aetna | EBR ASO | $47.60 | ↓ -33% |
| Coventry/First Health | Commercial | $52.36 | ↓ -27% |
| Highmark BCBS of PA | Managed Care | $56.06 | ↓ -21% |
| InterGroup | PPO | $59.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $65.45 | ↓ -8% |
| UPMC Health Plan | CHIP | $66.86 | ↓ -6% |
| Cigna Behavioral Health | Commercial | $71.40 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $85.98 | ↑ +20% |
| Private Health Care Systems | PPO | $89.25 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $95.20 | ↑ +33% |
| American Healthcare Group | Commercial | $95.20 | ↑ +33% |
| National Provider Network | PPO | $97.58 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $107.10 | ↑ +50% |
| Health Payors Organization | Commercial | $107.10 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Indemnity | $115.14 | ↑ +61% |
| UPMC Health Plan | Managed Medicare | $184.55 | ↑ +158% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $227.19 | ↑ +218% |
| Aetna of PA | Medicare | $232.46 | ↑ +226% |
| AmeriHealth Caritas | Medicare | $239.10 | ↑ +235% |
| Highmark Wholecare (prev Gateway) | Medicare | $239.10 | ↑ +235% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $239.10 | ↑ +235% |
| Aetna | Medicare | $243.53 | ↑ +241% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lip surgery procedure at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $2,225.40 | $18.77 – $3,152.65 |
| UPMC Northwest | Seneca | $124.20 | $48.19 – $239.10 |
| UPMC Wellsboro | Wellsboro | $121.80 | $36.54 – $182.70 |
| UPMC Williamsport | Williamsport | $114.60 | $76.00 – $239.08 |