healthcosts.net
Ophthalmic mitomycin at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,869.60
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.
$2,337.00
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.
$348.95 with Highmark BCBS of PA vs $2,103.30 with Multiplan — 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 | $348.95 | ↓ -81% |
| UPMC Health Plan | Commercial | $359.60 | ↓ -81% |
| UPMC Health Plan | CHIP | $455.39 | ↓ -76% |
| Aetna | Medicare | $584.25 | ↓ -69% |
| Aetna | Neighborhood Network | $652.02 | ↓ -65% |
| Aetna | Home Depot Employer Group | $711.62 | ↓ -62% |
| Aetna | NBR ASO/FI | $724.47 | ↓ -61% |
| Cigna | New Business ASO | $794.58 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $811.64 | ↓ -57% |
| Bravo | Medicare | $817.95 | ↓ -56% |
| Aetna | EBR FI | $888.06 | ↓ -53% |
| Aetna | EBR ASO | $934.80 | ↓ -50% |
| Cigna | Commercial | $934.80 | ↓ -50% |
| Highmark BCBS of PA | Managed Care - Social Mission | $992.90 | ↓ -47% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,021.12 | ↓ -45% |
| Coventry/First Health | Commercial | $1,028.28 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,168.50 | ↓ -38% |
| InterGroup | PPO | $1,168.50 | ↓ -38% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,285.35 | ↓ -31% |
| Highmark BCBS of PA | Managed Care | $1,329.79 | ↓ -29% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,367.63 | ↓ -27% |
| Cigna Behavioral Health | Commercial | $1,402.20 | ↓ -25% |
| Private Health Care Systems | PPO | $1,752.75 | ↓ -6% |
| American Healthcare Group | Commercial | $1,869.60 | ↑ +0% |
| InterGroup | Approved National Affiliated PPO Business | $1,869.60 | ↑ +0% |
| National Provider Network | PPO | $1,916.34 | ↑ +3% |
| Health Payors Organization | Commercial | $2,103.30 | ↑ +13% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $2,103.30 | ↑ +13% |
Visitor-reported prices
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Ophthalmic mitomycin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,930.20 | $352.28 – $2,085.05 |
| UPMC Presbyterian | Pittsburgh | $1,930.20 | $352.28 – $2,734.45 |
| UPMC St. Margaret | Pittsburgh | $1,516.80 | $352.28 – $1,611.60 |
| UPMC Western Psychiatric | Pittsburgh | $1,930.20 | $345.20 – $2,734.45 |
| UPMC Muncy | Muncy | $1,663.20 | $415.80 – $2,494.80 |
| UPMC Northwest | Seneca | $1,516.80 | $474.00 – $1,611.60 |
| UPMC Wellsboro | Wellsboro | $1,663.20 | $498.96 – $2,494.80 |