healthcosts.net
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$6,685.80
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.
?
What you pay up front if you don't use insurance.
$11,143.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$567.18 with Highmark BCBS of PA vs $10,028.70 with Health Payors Organization — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $567.18 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $712.32 | ↓ -89% |
| United Healthcare Community Plan for Families | PA Medicaid | $744.69 | ↓ -89% |
| UPMC Health Plan | Managed Medicare | $808.56 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $960.33 | ↓ -86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $995.37 | ↓ -85% |
| Aetna of PA | Medicare | $1,018.46 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,024.70 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $1,047.56 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,047.56 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,047.56 | ↓ -84% |
| Aetna | Medicare | $1,066.96 | ↓ -84% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,103.57 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $1,239.79 | ↓ -81% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,277.40 | ↓ -81% |
| UPMC Health Plan | Commercial | $1,381.65 | ↓ -79% |
| Highmark BCBS of PA | Managed Care | $1,710.62 | ↓ -74% |
| UPMC Health Plan | CHIP | $1,749.72 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,401.62 | ↓ -64% |
| Aetna | Neighborhood Network | $3,108.90 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,216.34 | ↓ -52% |
| Aetna | Home Depot Employer Group | $3,393.04 | ↓ -49% |
| Aetna | NBR ASO/FI | $3,454.33 | ↓ -48% |
| Cigna | New Business ASO | $3,788.62 | ↓ -43% |
| Bravo | Medicare | $3,900.05 | ↓ -42% |
| Aetna | EBR FI | $4,234.34 | ↓ -37% |
| Cigna | Commercial | $4,457.20 | ↓ -33% |
| Aetna | EBR ASO | $4,457.20 | ↓ -33% |
| Coventry/First Health | Commercial | $4,902.92 | ↓ -27% |
| InterGroup | PPO | $5,571.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $6,685.80 | ↑ +0% |
| Private Health Care Systems | PPO | $8,357.25 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $8,914.40 | ↑ +33% |
| American Healthcare Group | Commercial | $8,914.40 | ↑ +33% |
| National Provider Network | PPO | $9,137.26 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $10,028.70 | ↑ +50% |
| Health Payors Organization | Commercial | $10,028.70 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $9,867.00 | $572.58 – $13,187.75 |
| UPMC Presbyterian | Pittsburgh | $8,889.00 | $572.58 – $12,592.75 |
| UPMC St. Margaret | Pittsburgh | $4,797.00 | $572.58 – $6,795.75 |
| UPMC Wellsboro | Wellsboro | $7,850.40 | $662.62 – $8,831.70 |
| UPMC Williamsport | Williamsport | $6,491.40 | $662.62 – $8,655.20 |