healthcosts.net
New Patient Office Visit (level 2) at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$149.40
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.
$249.00
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.
$36.08 with Aetna of PA vs $238.45 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 |
|---|---|---|---|
| Aetna of PA | Medicare | $36.08 | ↓ -76% |
| UPMC Health Plan | Managed Medicaid | $38.86 | ↓ -74% |
| United Healthcare Community Plan for Families | PA Medicaid | $40.63 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicaid | $52.39 | ↓ -65% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $55.91 | ↓ -63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $60.21 | ↓ -60% |
| Aetna | Medicare | $62.25 | ↓ -58% |
| Cigna | Commercial | $63.91 | ↓ -57% |
| Cigna | New Business ASO | $63.91 | ↓ -57% |
| Aetna | Neighborhood Network | $69.47 | ↓ -54% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $74.31 | ↓ -50% |
| Aetna | Home Depot Employer Group | $75.82 | ↓ -49% |
| Aetna | NBR ASO/FI | $77.19 | ↓ -48% |
| Bravo | Medicare | $87.15 | ↓ -42% |
| Aetna | EBR FI | $94.62 | ↓ -37% |
| Aetna | EBR ASO | $99.60 | ↓ -33% |
| Coventry/First Health | Commercial | $109.56 | ↓ -27% |
| UPMC Work Partners | Workers Comp | $115.70 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $124.50 | ↓ -17% |
| InterGroup | PPO | $124.50 | ↓ -17% |
| Highmark BCBS of PA | Managed Care - Social Mission | $133.44 | ↓ -11% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $137.23 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $149.40 | ↑ +0% |
| Highmark BCBS of PA | Managed Care | $178.72 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Indemnity | $183.80 | ↑ +23% |
| Private Health Care Systems | PPO | $186.75 | ↑ +25% |
| American Healthcare Group | Commercial | $199.20 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $199.20 | ↑ +33% |
| National Provider Network | PPO | $204.18 | ↑ +37% |
| Health Payors Organization | Commercial | $224.10 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $224.10 | ↑ +50% |
| UPMC Health Plan | CHIP | $238.45 | ↑ +60% |
Visitor-reported prices
Comments
New Patient Office Visit (level 2) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $183.60 | $38.86 – $260.10 |
| UPMC Magee | Pittsburgh | $253.80 | $38.86 – $389.16 |
| UPMC Presbyterian | Pittsburgh | $200.40 | $38.86 – $283.90 |
| UPMC St. Margaret | Pittsburgh | $142.20 | $38.86 – $201.45 |
| UPMC Western Psychiatric | Pittsburgh | $200.40 | $73.52 – $252.45 |
| UPMC East | Monroeville | $255.60 | $36.08 – $340.80 |
| UPMC Hamot | Erie | $180.00 | $38.86 – $210.00 |
| UPMC Altoona | Altoona | $207.00 | $20.00 – $276.00 |