healthcosts.net
Shunt glaucoma baerveldt 350mm at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$5,882.40
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.
$9,804.00
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.
$484.55 with Highmark BCBS of PA vs $5,784.07 with UPMC Health Plan — 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 BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $484.55 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $663.84 | ↓ -89% |
| Aetna | Medicare | $691.50 | ↓ -88% |
| Highmark BCBS of PA | Managed Care - Social Mission | $731.78 | ↓ -88% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $745.08 | ↓ -87% |
| Aetna | Neighborhood Network | $771.71 | ↓ -87% |
| Aetna | Home Depot Employer Group | $842.25 | ↓ -86% |
| Aetna | NBR ASO/FI | $857.46 | ↓ -85% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $912.78 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $935.74 | ↓ -84% |
| Cigna | New Business ASO | $940.44 | ↓ -84% |
| Highmark BCBS of PA | Managed Care | $979.95 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity | $997.73 | ↓ -83% |
| Aetna | EBR FI | $1,051.08 | ↓ -82% |
| Aetna | EBR ASO | $1,106.40 | ↓ -81% |
| Cigna | Commercial | $1,106.40 | ↓ -81% |
| Coventry/First Health | Commercial | $1,217.04 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,383.00 | ↓ -76% |
| InterGroup | PPO | $1,383.00 | ↓ -76% |
| Cigna Behavioral Health | Commercial | $1,659.60 | ↓ -72% |
| Private Health Care Systems | PPO | $2,074.50 | ↓ -65% |
| American Healthcare Group | Commercial | $2,212.80 | ↓ -62% |
| InterGroup | Approved National Affiliated PPO Business | $2,212.80 | ↓ -62% |
| National Provider Network | PPO | $2,268.12 | ↓ -61% |
| Health Payors Organization | Commercial | $2,489.40 | ↓ -58% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $2,489.40 | ↓ -58% |
| UPMC Health Plan | Commercial | $4,567.35 | ↓ -22% |
| UPMC Health Plan | CHIP | $5,784.07 | ↓ -2% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Bravo | Medicare | not published by hospital | — |
Visitor-reported prices
Comments
Shunt glaucoma baerveldt 350mm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,235.60 | $489.17 – $8,393.41 |
| UPMC Presbyterian | Pittsburgh | $10,690.80 | $369.00 – $9,351.81 |
| UPMC St. Margaret | Pittsburgh | $4,636.80 | $489.17 – $7,097.47 |
| UPMC Muncy | Muncy | $5,572.20 | $343.35 – $2,060.10 |
| UPMC Northwest | Seneca | $4,636.80 | $1,257.60 – $6,999.24 |
| UPMC Wellsboro | Wellsboro | $6,739.20 | $491.94 – $2,459.70 |