healthcosts.net
Njx px nfrosgrm &/urtrgrm at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$2,703.60
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.
$4,506.00
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.
$350.48 with Highmark BCBS of PA vs $4,055.40 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $350.48 | ↓ -87% |
| UPMC Health Plan | Managed Medicare | $530.46 | ↓ -80% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $653.02 | ↓ -76% |
| Aetna of PA | Medicare | $668.17 | ↓ -75% |
| AmeriHealth Caritas | Medicare | $687.26 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicare | $687.26 | ↓ -75% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $687.26 | ↓ -75% |
| Aetna | Medicare | $699.99 | ↓ -74% |
| UPMC Work Partners | Workers Comp | $764.38 | ↓ -72% |
| Highmark BCBS of PA | Managed Care - Social Mission | $789.35 | ↓ -71% |
| Highmark BCBS of PA | Managed Care | $1,057.05 | ↓ -61% |
| UPMC Health Plan | Commercial | $1,239.17 | ↓ -54% |
| Aetna | Neighborhood Network | $1,257.17 | ↓ -54% |
| Aetna | Home Depot Employer Group | $1,372.08 | ↓ -49% |
| Aetna | NBR ASO/FI | $1,396.86 | ↓ -48% |
| Cigna | New Business ASO | $1,532.04 | ↓ -43% |
| Bravo | Medicare | $1,577.10 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,621.13 | ↓ -40% |
| Aetna | EBR FI | $1,712.28 | ↓ -37% |
| Cigna | Commercial | $1,802.40 | ↓ -33% |
| Aetna | EBR ASO | $1,802.40 | ↓ -33% |
| Coventry/First Health | Commercial | $1,982.64 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,171.04 | ↓ -20% |
| UPMC Health Plan | CHIP | $2,241.68 | ↓ -17% |
| InterGroup | PPO | $2,253.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,478.30 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $2,703.60 | ↑ +0% |
| Private Health Care Systems | PPO | $3,379.50 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $3,604.80 | ↑ +33% |
| American Healthcare Group | Commercial | $3,604.80 | ↑ +33% |
| National Provider Network | PPO | $3,694.92 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $4,055.40 | ↑ +50% |
| Health Payors Organization | Commercial | $4,055.40 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Njx px nfrosgrm &/urtrgrm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,292.00 | $353.81 – $3,247.00 |
| UPMC Presbyterian | Pittsburgh | $3,574.20 | $353.81 – $5,063.45 |
| UPMC St. Margaret | Pittsburgh | $1,726.20 | $353.81 – $2,445.45 |
| UPMC Northwest | Seneca | $908.40 | $577.11 – $1,286.90 |
| UPMC Somerset | Somerset | $1,266.00 | $346.93 – $1,582.50 |
| UPMC Williamsport | Williamsport | $845.40 | $560.64 – $1,127.20 |