healthcosts.net
Oral everolimus at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,208.40
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.
$2,014.00
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.
$0.87 with UPMC Health Plan vs $29.70 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $0.87 | ↓ -100% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1.37 | ↓ -100% |
| Geisinger | Medicaid/CHIP | $1.37 | ↓ -100% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1.37 | ↓ -100% |
| UPMC Health Plan | Commercial | $1.69 | ↓ -100% |
| UPMC Health Plan | CHIP | $3.19 | ↓ -100% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $5.80 | ↓ -100% |
| Aetna | Medicare | $8.25 | ↓ -99% |
| Aetna | Neighborhood Network | $9.21 | ↓ -99% |
| Aetna | Home Depot Employer Group | $10.05 | ↓ -99% |
| Aetna | NBR ASO/FI | $10.23 | ↓ -99% |
| Cigna | New Business ASO | $11.22 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $11.46 | ↓ -99% |
| Bravo | Medicare | $11.55 | ↓ -99% |
| Aetna | EBR FI | $12.54 | ↓ -99% |
| Aetna | EBR ASO | $13.20 | ↓ -99% |
| Cigna | Commercial | $13.20 | ↓ -99% |
| Coventry/First Health | Commercial | $14.52 | ↓ -99% |
| Highmark BCBS of PA | Managed Care - Social Mission | $16.50 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $16.50 | ↓ -99% |
| InterGroup | PPO | $16.50 | ↓ -99% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $16.97 | ↓ -99% |
| Cigna Behavioral Health | Commercial | $19.80 | ↓ -98% |
| Highmark BCBS of PA | Managed Care | $22.10 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Indemnity | $22.73 | ↓ -98% |
| Private Health Care Systems | PPO | $24.75 | ↓ -98% |
| American Healthcare Group | Commercial | $26.40 | ↓ -98% |
| InterGroup | Approved National Affiliated PPO Business | $26.40 | ↓ -98% |
| National Provider Network | PPO | $27.06 | ↓ -98% |
| Health Payors Organization | Commercial | $29.70 | ↓ -98% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $29.70 | ↓ -98% |
Visitor-reported prices
Comments
Oral everolimus at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,281.00 | $0.87 – $26.35 |
| UPMC Presbyterian | Pittsburgh | $1,610.40 | $0.87 – $42.50 |
| UPMC St. Margaret | Pittsburgh | $1,208.40 | $0.87 – $22.95 |
| UPMC Muncy | Muncy | $115.20 | $1.37 – $172.80 |
| UPMC Northwest | Seneca | $1,208.40 | $0.87 – $1,711.90 |
| UPMC Wellsboro | Wellsboro | $115.20 | $1.37 – $172.80 |
| UPMC Williamsport | Williamsport | $1,152.00 | $1.37 – $1,728.00 |