healthcosts.net
Replace g/c tube perc at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$2,467.80
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.
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What you pay up front if you don't use insurance.
$4,113.00
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.
$56.21 with UPMC Health Plan vs $8,163.02 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 | Managed Medicaid | $56.21 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $58.77 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $75.78 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $80.86 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $87.08 | ↓ -96% |
| UPMC Health Plan | Managed Medicare | $745.11 | ↓ -70% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $917.27 | ↓ -63% |
| Aetna of PA | Medicare | $938.54 | ↓ -62% |
| AmeriHealth Caritas | Medicare | $965.36 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $965.36 | ↓ -61% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $965.36 | ↓ -61% |
| Aetna | Medicare | $983.24 | ↓ -60% |
| UPMC Health Plan | Commercial | $1,093.07 | ↓ -56% |
| Aetna | Neighborhood Network | $1,147.53 | ↓ -53% |
| Aetna | Home Depot Employer Group | $1,252.41 | ↓ -49% |
| Aetna | NBR ASO/FI | $1,275.03 | ↓ -48% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,317.78 | ↓ -47% |
| UPMC Work Partners | Workers Comp | $1,374.34 | ↓ -44% |
| Cigna | New Business ASO | $1,398.42 | ↓ -43% |
| Bravo | Medicare | $1,439.55 | ↓ -42% |
| Aetna | EBR FI | $1,562.94 | ↓ -37% |
| Cigna | Commercial | $1,645.20 | ↓ -33% |
| Aetna | EBR ASO | $1,645.20 | ↓ -33% |
| UPMC Health Plan | CHIP | $1,739.81 | ↓ -29% |
| Coventry/First Health | Commercial | $1,809.72 | ↓ -27% |
| InterGroup | PPO | $2,056.50 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $2,467.80 | ↑ +0% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,967.91 | ↑ +20% |
| Private Health Care Systems | PPO | $3,084.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $3,290.40 | ↑ +33% |
| American Healthcare Group | Commercial | $3,290.40 | ↑ +33% |
| National Provider Network | PPO | $3,372.66 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $3,701.70 | ↑ +50% |
| Health Payors Organization | Commercial | $3,701.70 | ↑ +50% |
| Highmark BCBS of PA | Managed Care | $3,974.46 | ↑ +61% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6,095.40 | ↑ +147% |
| Highmark BCBS of PA | Commercial - Indemnity | $8,163.02 | ↑ +231% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Replace g/c tube perc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,076.80 | $56.21 – $4,358.80 |
| UPMC Presbyterian | Pittsburgh | $4,783.80 | $56.21 – $6,777.05 |
| UPMC St. Margaret | Pittsburgh | $2,620.80 | $56.21 – $3,712.80 |
| UPMC Northwest | Seneca | $2,695.80 | $56.21 – $3,819.05 |
| UPMC Somerset | Somerset | $3,972.00 | $56.21 – $4,965.00 |
| UPMC Wellsboro | Wellsboro | $3,755.20 | $35.64 – $1,150.09 |
| UPMC Williamsport | Williamsport | $3,105.00 | $56.21 – $4,140.00 |