healthcosts.net
Prim art mech thrmbc non-intracranial at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$12,590.40
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.
$20,984.00
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.
$3,637.71 with UPMC Health Plan vs $32,272.45 with Highmark BCBS of PA — 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 | Commercial | $3,637.71 | ↓ -71% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $5,209.83 | ↓ -59% |
| UPMC Work Partners | Workers Comp | $5,656.24 | ↓ -55% |
| UPMC Health Plan | CHIP | $5,790.06 | ↓ -54% |
| Aetna | Neighborhood Network | $5,854.54 | ↓ -53% |
| Aetna | Home Depot Employer Group | $6,389.63 | ↓ -49% |
| Aetna | NBR ASO/FI | $6,505.04 | ↓ -48% |
| Cigna | New Business ASO | $7,134.56 | ↓ -43% |
| Bravo | Medicare | $7,344.40 | ↓ -42% |
| Aetna | EBR FI | $7,973.92 | ↓ -37% |
| Cigna | Commercial | $8,393.60 | ↓ -33% |
| Aetna | EBR ASO | $8,393.60 | ↓ -33% |
| Coventry/First Health | Commercial | $9,232.96 | ↓ -27% |
| InterGroup | PPO | $10,492.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $11,541.20 | ↓ -8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $11,733.60 | ↓ -7% |
| Cigna Behavioral Health | Commercial | $12,590.40 | ↑ +0% |
| UPMC Health Plan | Managed Medicare | $14,270.88 | ↑ +13% |
| Highmark BCBS of PA | Managed Care | $15,713.00 | ↑ +25% |
| Private Health Care Systems | PPO | $15,738.00 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $16,787.20 | ↑ +33% |
| American Healthcare Group | Commercial | $16,787.20 | ↑ +33% |
| National Provider Network | PPO | $17,206.88 | ↑ +37% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $17,568.11 | ↑ +40% |
| Aetna of PA | Medicare | $17,975.56 | ↑ +43% |
| AmeriHealth Caritas | Medicare | $18,489.15 | ↑ +47% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,489.15 | ↑ +47% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,489.15 | ↑ +47% |
| Aetna | Medicare | $18,831.54 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $18,885.60 | ↑ +50% |
| Health Payors Organization | Commercial | $18,885.60 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $24,098.11 | ↑ +91% |
| Highmark BCBS of PA | Commercial - Indemnity | $32,272.45 | ↑ +156% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Prim art mech thrmbc non-intracranial at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $26,668.20 | $2,617.11 – $37,779.95 |
| UPMC Presbyterian | Pittsburgh | $21,964.80 | $931.20 – $31,116.80 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $5,352.00 | $993.28 – $18,487.43 |