healthcosts.net
Reptilase test at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$110.40
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.
$184.00
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.
$6.60 with UPMC Health Plan vs $125.10 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $6.60 | ↓ -94% |
| United Healthcare Community Plan for Families | PA Medicaid | $6.90 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $8.21 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $8.90 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $9.49 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $9.74 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $9.85 | ↓ -91% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10.11 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $10.23 | ↓ -91% |
| Aetna of PA | Medicare | $10.34 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $10.64 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $10.64 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10.64 | ↓ -90% |
| Aetna | Medicare | $10.84 | ↓ -90% |
| UPMC Health Plan | Commercial | $11.71 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $17.58 | ↓ -84% |
| Highmark BCBS of PA | Managed Care - Social Mission | $26.56 | ↓ -76% |
| Highmark BCBS of PA | Managed Care | $35.56 | ↓ -68% |
| Aetna | Neighborhood Network | $38.78 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $41.97 | ↓ -62% |
| Aetna | Home Depot Employer Group | $42.33 | ↓ -62% |
| UPMC Health Plan | CHIP | $42.45 | ↓ -62% |
| Aetna | NBR ASO/FI | $43.09 | ↓ -61% |
| Cigna | New Business ASO | $47.26 | ↓ -57% |
| Bravo | Medicare | $48.65 | ↓ -56% |
| Aetna | EBR FI | $52.82 | ↓ -52% |
| Cigna | Commercial | $55.60 | ↓ -50% |
| Aetna | EBR ASO | $55.60 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity | $56.21 | ↓ -49% |
| Coventry/First Health | Commercial | $61.16 | ↓ -45% |
| InterGroup | PPO | $69.50 | ↓ -37% |
| Cigna Behavioral Health | Commercial | $83.40 | ↓ -24% |
| Private Health Care Systems | PPO | $104.25 | ↓ -6% |
| InterGroup | Approved National Affiliated PPO Business | $111.20 | ↑ +1% |
| American Healthcare Group | Commercial | $111.20 | ↑ +1% |
| National Provider Network | PPO | $113.98 | ↑ +3% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $125.10 | ↑ +13% |
| Health Payors Organization | Commercial | $125.10 | ↑ +13% |
Visitor-reported prices
Comments
Reptilase test at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $86.40 | $6.60 – $122.40 |
| UPMC Presbyterian | Pittsburgh | $774.00 | $6.00 – $1,096.50 |
| UPMC St. Margaret | Pittsburgh | $97.20 | $6.60 – $137.70 |
| UPMC Muncy | Muncy | $87.60 | $6.60 – $116.80 |
| UPMC Northwest | Seneca | $83.40 | $6.60 – $118.15 |
| UPMC Wellsboro | Wellsboro | $105.60 | $6.00 – $118.80 |
| UPMC Williamsport | Williamsport | $87.60 | $6.60 – $116.80 |