healthcosts.net
Lung function test (mbc/mvv) at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$79.80
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.
$133.00
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.
$9.90 with UPMC Health Plan vs $119.70 with Health Payors Organization — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $9.90 | ↓ -88% |
| United Healthcare Community Plan for Families | PA Medicaid | $10.35 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $13.35 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $14.24 | ↓ -82% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $15.34 | ↓ -81% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.33 | ↓ -77% |
| Aetna | Neighborhood Network | $37.11 | ↓ -53% |
| Aetna | Home Depot Employer Group | $40.50 | ↓ -49% |
| Aetna | NBR ASO/FI | $41.23 | ↓ -48% |
| Highmark BCBS of PA | Managed Care - Social Mission | $41.28 | ↓ -48% |
| Cigna | New Business ASO | $45.22 | ↓ -43% |
| Bravo | Medicare | $46.55 | ↓ -42% |
| UPMC Health Plan | Managed Medicare | $47.21 | ↓ -41% |
| Aetna | EBR FI | $50.54 | ↓ -37% |
| UPMC Health Plan | Commercial | $51.69 | ↓ -35% |
| Cigna | Commercial | $53.20 | ↓ -33% |
| Aetna | EBR ASO | $53.20 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $55.28 | ↓ -31% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $58.11 | ↓ -27% |
| Coventry/First Health | Commercial | $58.52 | ↓ -27% |
| Aetna of PA | Medicare | $59.46 | ↓ -25% |
| AmeriHealth Caritas | Medicare | $61.16 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $61.16 | ↓ -23% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $61.16 | ↓ -23% |
| Aetna | Medicare | $62.29 | ↓ -22% |
| UPMC Health Plan | CHIP | $65.46 | ↓ -18% |
| InterGroup | PPO | $66.50 | ↓ -17% |
| UPMC Work Partners | Workers Comp | $70.99 | ↓ -11% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $77.61 | ↓ -3% |
| Cigna Behavioral Health | Commercial | $79.80 | ↑ +0% |
| Private Health Care Systems | PPO | $99.75 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Indemnity | $103.93 | ↑ +30% |
| InterGroup | Approved National Affiliated PPO Business | $106.40 | ↑ +33% |
| American Healthcare Group | Commercial | $106.40 | ↑ +33% |
| National Provider Network | PPO | $109.06 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $119.70 | ↑ +50% |
| Health Payors Organization | Commercial | $119.70 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lung function test (mbc/mvv) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $109.80 | $9.90 – $155.55 |
| UPMC Presbyterian | Pittsburgh | $100.20 | $6.48 – $141.95 |
| UPMC St. Margaret | Pittsburgh | $69.60 | $9.90 – $98.60 |
| UPMC Northwest | Seneca | $115.80 | $9.90 – $164.05 |
| UPMC Somerset | Somerset | $155.40 | $6.21 – $76.51 |
| UPMC Wellsboro | Wellsboro | $109.60 | $6.91 – $123.30 |
| UPMC Williamsport | Williamsport | $133.20 | $6.91 – $177.60 |