healthcosts.net
Pulse ox single at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$91.20
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.
$152.00
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.
$2.18 with UPMC Health Plan vs $136.80 with Multiplan — 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 | Managed Medicaid | $2.18 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $2.28 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2.94 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3.13 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3.37 | ↓ -96% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $7.04 | ↓ -92% |
| Highmark BCBS of PA | Managed Care - Social Mission | $15.87 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $20.74 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $21.25 | ↓ -77% |
| UPMC Health Plan | Commercial | $23.26 | ↓ -74% |
| UPMC Health Plan | CHIP | $29.46 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $29.83 | ↓ -67% |
| Aetna | Medicare | $38.00 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity | $39.95 | ↓ -56% |
| Aetna | Neighborhood Network | $42.41 | ↓ -53% |
| Aetna | Home Depot Employer Group | $46.28 | ↓ -49% |
| Aetna | NBR ASO/FI | $47.12 | ↓ -48% |
| Cigna | New Business ASO | $51.68 | ↓ -43% |
| Bravo | Medicare | $53.20 | ↓ -42% |
| Aetna | EBR FI | $57.76 | ↓ -37% |
| Aetna | EBR ASO | $60.80 | ↓ -33% |
| Cigna | Commercial | $60.80 | ↓ -33% |
| Coventry/First Health | Commercial | $66.88 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $76.00 | ↓ -17% |
| InterGroup | PPO | $76.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $91.20 | ↑ +0% |
| Private Health Care Systems | PPO | $114.00 | ↑ +25% |
| American Healthcare Group | Commercial | $121.60 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $121.60 | ↑ +33% |
| National Provider Network | PPO | $124.64 | ↑ +37% |
| Health Payors Organization | Commercial | $136.80 | ↑ +50% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $136.80 | ↑ +50% |
Visitor-reported prices
Comments
Pulse ox single at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $201.00 | $2.18 – $284.75 |
| UPMC Presbyterian | Pittsburgh | $141.00 | $2.18 – $199.75 |
| UPMC St. Margaret | Pittsburgh | $168.00 | $2.18 – $238.00 |
| UPMC Muncy | Muncy | $62.40 | $2.18 – $83.20 |
| UPMC Northwest | Seneca | $33.00 | $2.18 – $46.75 |
| UPMC Somerset | Somerset | $98.40 | $2.18 – $123.00 |
| UPMC Wellsboro | Wellsboro | $75.80 | $2.18 – $81.00 |
| UPMC Williamsport | Williamsport | $62.40 | $2.18 – $24.80 |