healthcosts.net
Mayo analysis gene smn1 dosage/deletion at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$730.20
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.
$1,217.00
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.
$83.66 with Highmark BCBS of PA vs $1,004.36 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 | $83.66 | ↓ -89% |
| UPMC Health Plan | Managed Medicare | $114.20 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $120.56 | ↓ -83% |
| United Healthcare Community Plan for Families | PA Medicaid | $126.04 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $126.35 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $135.40 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $137.00 | ↓ -81% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $140.59 | ↓ -81% |
| Aetna of PA | Medicare | $143.85 | ↓ -80% |
| AmeriHealth Caritas | Medicare | $147.96 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicare | $147.96 | ↓ -80% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $147.96 | ↓ -80% |
| Aetna | Medicare | $150.70 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $162.54 | ↓ -78% |
| Highmark BCBS of PA | Managed Care | $169.20 | ↓ -77% |
| Aetna | Neighborhood Network | $172.42 | ↓ -76% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $173.43 | ↓ -76% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $186.78 | ↓ -74% |
| Aetna | Home Depot Employer Group | $188.18 | ↓ -74% |
| Aetna | NBR ASO/FI | $191.58 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $199.71 | ↓ -73% |
| Cigna | New Business ASO | $210.12 | ↓ -71% |
| Bravo | Medicare | $216.30 | ↓ -70% |
| Aetna | EBR FI | $234.84 | ↓ -68% |
| Cigna | Commercial | $247.20 | ↓ -66% |
| Aetna | EBR ASO | $247.20 | ↓ -66% |
| Highmark BCBS of PA | Commercial - Indemnity | $267.46 | ↓ -63% |
| Coventry/First Health | Commercial | $271.92 | ↓ -63% |
| InterGroup | PPO | $309.00 | ↓ -58% |
| Cigna Behavioral Health | Commercial | $370.80 | ↓ -49% |
| Private Health Care Systems | PPO | $463.50 | ↓ -37% |
| InterGroup | Approved National Affiliated PPO Business | $494.40 | ↓ -32% |
| American Healthcare Group | Commercial | $494.40 | ↓ -32% |
| National Provider Network | PPO | $506.76 | ↓ -31% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $556.20 | ↓ -24% |
| Health Payors Organization | Commercial | $556.20 | ↓ -24% |
| UPMC Health Plan | Commercial | $649.03 | ↓ -11% |
| UPMC Health Plan | CHIP | $1,004.36 | ↑ +38% |
Visitor-reported prices
Comments
Mayo analysis gene smn1 dosage/deletion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,261.80 | $84.46 – $487.90 |
| UPMC Presbyterian | Pittsburgh | $2,547.60 | $84.46 – $525.30 |
| UPMC St. Margaret | Pittsburgh | $2,547.60 | $84.46 – $1,034.45 |
| UPMC Muncy | Muncy | $1,135.80 | $120.56 – $918.40 |
| UPMC Northwest | Seneca | $2,547.60 | $120.56 – $525.30 |
| UPMC Somerset | Somerset | $792.60 | $82.82 – $990.75 |
| UPMC Wellsboro | Wellsboro | $2,514.40 | $109.60 – $1,033.20 |
| UPMC Williamsport | Williamsport | $1,192.80 | $120.56 – $964.00 |