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Sirolimus, oral at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$63.00
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.
$79.00
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.
$0.55 with UPMC Health Plan vs $47.43 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 | $0.55 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.87 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $0.87 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $0.87 | ↓ -99% |
| UPMC Health Plan | Commercial | $1.07 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $1.65 | ↓ -97% |
| UPMC Health Plan | CHIP | $3.10 | ↓ -95% |
| Aetna | Medicare | $5.75 | ↓ -91% |
| Aetna | Neighborhood Network | $6.42 | ↓ -90% |
| Aetna | Home Depot Employer Group | $7.00 | ↓ -89% |
| Aetna | NBR ASO/FI | $7.13 | ↓ -89% |
| Cigna | New Business ASO | $7.82 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $7.99 | ↓ -87% |
| Bravo | Medicare | $8.05 | ↓ -87% |
| Aetna | EBR FI | $8.74 | ↓ -86% |
| Aetna | EBR ASO | $9.20 | ↓ -85% |
| Cigna | Commercial | $9.20 | ↓ -85% |
| Coventry/First Health | Commercial | $10.12 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $11.50 | ↓ -82% |
| InterGroup | PPO | $11.50 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $12.10 | ↓ -81% |
| Cigna Behavioral Health | Commercial | $13.80 | ↓ -78% |
| Private Health Care Systems | PPO | $17.25 | ↓ -73% |
| American Healthcare Group | Commercial | $18.40 | ↓ -71% |
| InterGroup | Approved National Affiliated PPO Business | $18.40 | ↓ -71% |
| National Provider Network | PPO | $18.86 | ↓ -70% |
| Health Payors Organization | Commercial | $20.70 | ↓ -67% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $20.70 | ↓ -67% |
| Highmark BCBS of PA | Managed Care - Social Mission | $34.43 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $35.41 | ↓ -44% |
| Highmark BCBS of PA | Managed Care | $46.11 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Indemnity | $47.43 | ↓ -25% |
Visitor-reported prices
Comments
Sirolimus, oral at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $300.00 | $0.55 – $24.65 |
| UPMC Presbyterian | Pittsburgh | $1,122.00 | $0.55 – $72.25 |
| UPMC St. Margaret | Pittsburgh | $100.00 | $0.55 – $106.25 |
| UPMC Western Psychiatric | Pittsburgh | $300.00 | $0.87 – $425.00 |
| UPMC Muncy | Muncy | $180.00 | $0.87 – $202.50 |
| UPMC Somerset | Somerset | $20.40 | $0.87 – $11.98 |
| UPMC Wellsboro | Wellsboro | $180.00 | $0.87 – $202.50 |
| UPMC Williamsport | Williamsport | $180.00 | $0.87 – $202.50 |