healthcosts.net
Pten gene dup/delet variant at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$575.40
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.
$959.00
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.
$51.14 with Highmark BCBS of PA vs $504.90 with Health Payors Organization — 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 BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $51.14 | ↓ -91% |
| Highmark BCBS of PA | Managed Care - Social Mission | $77.23 | ↓ -87% |
| Highmark BCBS of PA | Managed Care | $103.42 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $122.06 | ↓ -79% |
| Aetna | Neighborhood Network | $156.52 | ↓ -73% |
| Highmark BCBS of PA | Commercial - Indemnity | $163.47 | ↓ -72% |
| Aetna | Home Depot Employer Group | $170.82 | ↓ -70% |
| Aetna | NBR ASO/FI | $173.91 | ↓ -70% |
| Cigna | New Business ASO | $190.74 | ↓ -67% |
| UPMC Health Plan | CHIP | $196.35 | ↓ -66% |
| Bravo | Medicare | $196.35 | ↓ -66% |
| Aetna | EBR FI | $213.18 | ↓ -63% |
| Cigna | Commercial | $224.40 | ↓ -61% |
| Aetna | EBR ASO | $224.40 | ↓ -61% |
| Coventry/First Health | Commercial | $246.84 | ↓ -57% |
| UPMC Health Plan | Managed Medicare | $250.08 | ↓ -57% |
| UPMC Health Plan | Commercial | $252.45 | ↓ -56% |
| InterGroup | PPO | $280.50 | ↓ -51% |
| UPMC Work Partners | Workers Comp | $296.49 | ↓ -48% |
| Geisinger | Medicaid/CHIP | $300.00 | ↓ -48% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $307.86 | ↓ -46% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $308.55 | ↓ -46% |
| Aetna of PA | Medicare | $315.00 | ↓ -45% |
| AmeriHealth Caritas | Medicare | $324.00 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicare | $324.00 | ↓ -44% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $324.00 | ↓ -44% |
| Aetna | Medicare | $330.00 | ↓ -43% |
| Cigna Behavioral Health | Commercial | $336.60 | ↓ -42% |
| Private Health Care Systems | PPO | $420.75 | ↓ -27% |
| InterGroup | Approved National Affiliated PPO Business | $448.80 | ↓ -22% |
| American Healthcare Group | Commercial | $448.80 | ↓ -22% |
| National Provider Network | PPO | $460.02 | ↓ -20% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $504.90 | ↓ -12% |
| Health Payors Organization | Commercial | $504.90 | ↓ -12% |
Visitor-reported prices
Comments
Pten gene dup/delet variant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $357.00 | $51.62 – $505.75 |
| UPMC Presbyterian | Pittsburgh | $336.60 | $51.62 – $476.85 |
| UPMC St. Margaret | Pittsburgh | $336.60 | $51.62 – $476.85 |
| UPMC Northwest | Seneca | $336.60 | $132.72 – $476.85 |
| UPMC Williamsport | Williamsport | $564.60 | $234.24 – $752.80 |