healthcosts.net
Procainamide 100 mg/ml injection (wrapper) at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$222.40
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.
$278.00
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.
$20.37 with Aetna vs $362.47 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 |
|---|---|---|---|
| Aetna | Neighborhood Network | $20.37 | ↓ -91% |
| Aetna | Home Depot Employer Group | $22.23 | ↓ -90% |
| Aetna | NBR ASO/FI | $22.63 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $24.74 | ↓ -89% |
| Cigna | New Business ASO | $24.82 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $25.35 | ↓ -89% |
| Bravo | Medicare | $25.55 | ↓ -89% |
| Aetna | EBR FI | $27.74 | ↓ -88% |
| Cigna | Commercial | $29.20 | ↓ -87% |
| Aetna | EBR ASO | $29.20 | ↓ -87% |
| Coventry/First Health | Commercial | $32.12 | ↓ -86% |
| InterGroup | PPO | $36.50 | ↓ -84% |
| Cigna Behavioral Health | Commercial | $43.80 | ↓ -80% |
| Private Health Care Systems | PPO | $54.75 | ↓ -75% |
| InterGroup | Approved National Affiliated PPO Business | $58.40 | ↓ -74% |
| American Healthcare Group | Commercial | $58.40 | ↓ -74% |
| National Provider Network | PPO | $59.86 | ↓ -73% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $65.70 | ↓ -70% |
| Health Payors Organization | Commercial | $65.70 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $70.40 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $72.40 | ↓ -67% |
| Highmark BCBS of PA | Managed Care | $94.28 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity | $96.96 | ↓ -56% |
| UPMC Health Plan | CHIP | $169.78 | ↓ -24% |
| UPMC Health Plan | Managed Medicaid | $186.07 | ↓ -16% |
| UPMC Health Plan | Managed Medicare | $245.65 | ↑ +10% |
| Geisinger | Medicaid/CHIP | $294.69 | ↑ +33% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $294.69 | ↑ +33% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $294.69 | ↑ +33% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $302.41 | ↑ +36% |
| Aetna of PA | Medicare | $309.42 | ↑ +39% |
| AmeriHealth Caritas | Medicare | $318.27 | ↑ +43% |
| Highmark Wholecare (prev Gateway) | Medicare | $318.27 | ↑ +43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $318.27 | ↑ +43% |
| Aetna | Medicare | $324.16 | ↑ +46% |
| UPMC Health Plan | Commercial | $362.47 | ↑ +63% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Procainamide 100 mg/ml injection (wrapper) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $225.00 | $24.98 – $324.16 |
| UPMC Presbyterian | Pittsburgh | $225.00 | $24.98 – $324.16 |
| UPMC St. Margaret | Pittsburgh | $111.60 | $24.98 – $318.24 |
| UPMC Western Psychiatric | Pittsburgh | $225.00 | $24.47 – $318.27 |
| UPMC Muncy | Muncy | $533.60 | $83.10 – $498.60 |
| UPMC Somerset | Somerset | $36.00 | $3.03 – $294.69 |
| UPMC Wellsboro | Wellsboro | $533.60 | $99.72 – $498.60 |
| UPMC Williamsport | Williamsport | $533.60 | $180.89 – $600.30 |