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Ring fx reform 11-13x17mm at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,800.00
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.
$3,000.00
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.
$120.48 with Highmark Wholecare (prev Gateway) vs $1,671.85 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $120.48 | ↓ -93% |
| Aetna | Medicare | $125.50 | ↓ -93% |
| Aetna | Neighborhood Network | $140.06 | ↓ -92% |
| Aetna | Home Depot Employer Group | $152.86 | ↓ -92% |
| Aetna | NBR ASO/FI | $155.62 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $165.66 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $169.83 | ↓ -91% |
| Cigna | New Business ASO | $170.68 | ↓ -91% |
| Aetna | EBR FI | $190.76 | ↓ -89% |
| Aetna | EBR ASO | $200.80 | ↓ -89% |
| Cigna | Commercial | $200.80 | ↓ -89% |
| Coventry/First Health | Commercial | $220.88 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $251.00 | ↓ -86% |
| InterGroup | PPO | $251.00 | ↓ -86% |
| Cigna Behavioral Health | Commercial | $301.20 | ↓ -83% |
| Private Health Care Systems | PPO | $376.50 | ↓ -79% |
| American Healthcare Group | Commercial | $401.60 | ↓ -78% |
| InterGroup | Approved National Affiliated PPO Business | $401.60 | ↓ -78% |
| National Provider Network | PPO | $411.64 | ↓ -77% |
| Health Payors Organization | Commercial | $451.80 | ↓ -75% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $451.80 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $811.94 | ↓ -55% |
| UPMC Health Plan | Commercial | $955.64 | ↓ -47% |
| UPMC Health Plan | CHIP | $1,210.22 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,226.21 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,248.49 | ↓ -31% |
| Highmark BCBS of PA | Managed Care | $1,642.06 | ↓ -9% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,671.85 | ↓ -7% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Bravo | Medicare | not published by hospital | — |
Visitor-reported prices
Comments
Ring fx reform 11-13x17mm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $3,167.40 | $63.60 – $1,956.70 |
| UPMC St. Margaret | Pittsburgh | $456.60 | $127.40 – $1,485.02 |
| UPMC Muncy | Muncy | $422.40 | $98.70 – $592.20 |