healthcosts.net
Shoulder MRI (with contrast) at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$5,313.60
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.
$8,856.00
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.
$439.03 with UPMC Health Plan vs $7,970.40 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 | Commercial | $439.03 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $539.76 | ↓ -90% |
| UPMC Health Plan | Managed Medicare | $627.89 | ↓ -88% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $772.96 | ↓ -85% |
| Aetna of PA | Medicare | $790.89 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $813.49 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $813.49 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $813.49 | ↓ -85% |
| Aetna | Medicare | $828.55 | ↓ -84% |
| Premier Comp Solutions | Worker's Comp | $1,213.54 | ↓ -77% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,215.65 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $1,304.55 | ↓ -75% |
| UPMC Health Plan | CHIP | $1,591.30 | ↓ -70% |
| Highmark BCBS of PA | Managed Care | $1,627.93 | ↓ -69% |
| Bravo | Medicare | $2,214.00 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,292.90 | ↓ -57% |
| Aetna | Neighborhood Network | $2,470.82 | ↓ -54% |
| Aetna | Home Depot Employer Group | $2,696.65 | ↓ -49% |
| Aetna | NBR ASO/FI | $2,745.36 | ↓ -48% |
| Cigna | New Business ASO | $3,011.04 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,070.80 | ↓ -42% |
| Aetna | EBR FI | $3,365.28 | ↓ -37% |
| Cigna | Commercial | $3,542.40 | ↓ -33% |
| Aetna | EBR ASO | $3,542.40 | ↓ -33% |
| Coventry/First Health | Commercial | $3,896.64 | ↓ -27% |
| InterGroup | PPO | $4,428.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4,870.80 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $5,313.60 | ↑ +0% |
| Private Health Care Systems | PPO | $6,642.00 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $7,084.80 | ↑ +33% |
| American Healthcare Group | Commercial | $7,084.80 | ↑ +33% |
| National Provider Network | PPO | $7,261.92 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $7,970.40 | ↑ +50% |
| Health Payors Organization | Commercial | $7,970.40 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder MRI (with contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,621.20 | $441.61 – $6,546.70 |
| UPMC Magee | Pittsburgh | $5,191.20 | $463.21 – $7,959.84 |
| UPMC Presbyterian | Pittsburgh | $8,004.00 | $369.30 – $11,339.00 |
| UPMC St. Margaret | Pittsburgh | $4,742.40 | $442.69 – $6,718.40 |
| UPMC East | Monroeville | $5,074.20 | $437.75 – $6,765.60 |
| UPMC Hamot | Erie | $1,948.80 | $201.09 – $2,273.60 |
| UPMC Horizon-Greenville | Greenville | $4,192.80 | $443.23 – $5,939.80 |
| UPMC Jameson | New Castle | $3,155.40 | $327.20 – $4,365.68 |