healthcosts.net
Sm-153 lexidron ther at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
not published by hospital
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.
$8,937.50
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.
$2,493.56 with Aetna vs $28,796.03 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 |
|---|---|---|---|
| Aetna | Neighborhood Network | $2,493.56 | — |
| Aetna | Home Depot Employer Group | $2,721.47 | — |
| Aetna | NBR ASO/FI | $2,770.62 | — |
| Cigna | New Business ASO | $3,038.75 | — |
| Bravo | Medicare | $3,128.12 | — |
| Aetna | EBR FI | $3,396.25 | — |
| Cigna | Commercial | $3,575.00 | — |
| Aetna | EBR ASO | $3,575.00 | — |
| UPMC Health Plan | Managed Medicare | $3,596.91 | — |
| Coventry/First Health | Commercial | $3,932.50 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $4,427.96 | — |
| InterGroup | PPO | $4,468.75 | — |
| Aetna of PA | Medicare | $4,530.66 | — |
| AmeriHealth Caritas | Medicare | $4,660.10 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $4,660.10 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4,660.10 | — |
| Aetna | Medicare | $4,746.40 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4,915.62 | — |
| Cigna Behavioral Health | Commercial | $5,362.50 | — |
| Private Health Care Systems | PPO | $6,703.12 | — |
| InterGroup | Approved National Affiliated PPO Business | $7,150.00 | — |
| American Healthcare Group | Commercial | $7,150.00 | — |
| National Provider Network | PPO | $7,328.75 | — |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $8,043.75 | — |
| Health Payors Organization | Commercial | $8,043.75 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $10,621.85 | — |
| UPMC Health Plan | Commercial | $20,905.36 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $20,905.99 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $21,500.08 | — |
| UPMC Health Plan | CHIP | $26,474.45 | — |
| Highmark BCBS of PA | Managed Care | $27,999.16 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $28,796.03 | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Sm-153 lexidron ther at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $31,245.00 | $4,660.10 – $44,263.75 |
| UPMC St. Margaret | Pittsburgh | not published | $2,252.25 – $10,723.00 |
| UPMC Muncy | Muncy | $12,410.40 | $3,102.60 – $18,615.60 |
| UPMC Somerset | Somerset | $5,947.80 | $3,903.74 – $7,434.75 |
| UPMC Wellsboro | Wellsboro | $15,008.80 | $3,376.98 – $16,884.90 |
| UPMC Northwest | Seneca | not published | $3,575.00 – $7,596.88 |