healthcosts.net
Passy muir valve metal trach at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$241.20
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.
$402.00
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.
$96.48 with Highmark Wholecare (prev Gateway) vs $478.80 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 Wholecare (prev Gateway) | Medicaid | $96.48 | ↓ -60% |
| Aetna | Medicare | $100.50 | ↓ -58% |
| Aetna | Neighborhood Network | $112.16 | ↓ -53% |
| Aetna | Home Depot Employer Group | $122.41 | ↓ -49% |
| Aetna | NBR ASO/FI | $124.62 | ↓ -48% |
| Cigna | New Business ASO | $136.68 | ↓ -43% |
| Aetna | EBR FI | $152.76 | ↓ -37% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $155.88 | ↓ -35% |
| Aetna | EBR ASO | $160.80 | ↓ -33% |
| Cigna | Commercial | $160.80 | ↓ -33% |
| Coventry/First Health | Commercial | $176.88 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $201.00 | ↓ -17% |
| InterGroup | PPO | $201.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $221.10 | ↓ -8% |
| UPMC Work Partners | Workers Comp | $222.54 | ↓ -8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $235.41 | ↓ -2% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $239.69 | ↓ -1% |
| Cigna Behavioral Health | Commercial | $241.20 | ↑ +0% |
| Private Health Care Systems | PPO | $301.50 | ↑ +25% |
| Highmark BCBS of PA | Managed Care | $315.25 | ↑ +31% |
| Highmark BCBS of PA | Commercial - Indemnity | $320.97 | ↑ +33% |
| American Healthcare Group | Commercial | $321.60 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $321.60 | ↑ +33% |
| National Provider Network | PPO | $329.64 | ↑ +37% |
| Health Payors Organization | Commercial | $361.80 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $361.80 | ↑ +50% |
| UPMC Health Plan | Commercial | $378.08 | ↑ +57% |
| UPMC Health Plan | CHIP | $478.80 | ↑ +99% |
| Bravo | Medicare | not published by hospital | — |
Visitor-reported prices
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Passy muir valve metal trach at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,018.20 | $157.36 – $1,442.45 |
| UPMC Presbyterian | Pittsburgh | $1,261.20 | $55.20 – $774.13 |
| UPMC Muncy | Muncy | $289.80 | $72.45 – $386.40 |
| UPMC Northwest | Seneca | $346.20 | $144.25 – $579.39 |
| UPMC Wellsboro | Wellsboro | $350.40 | $78.84 – $394.20 |
| UPMC Williamsport | Williamsport | $289.80 | $96.00 – $386.40 |