healthcosts.net
Stent bili dbl pgtl 10fx5cm at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$720.00
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.
$1,200.00
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.
$29.04 with Highmark Wholecare (prev Gateway) vs $861.28 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 Wholecare (prev Gateway) | Medicaid | $29.04 | ↓ -96% |
| Aetna | Medicare | $30.25 | ↓ -96% |
| Aetna | Neighborhood Network | $33.76 | ↓ -95% |
| Aetna | Home Depot Employer Group | $36.84 | ↓ -95% |
| Aetna | NBR ASO/FI | $37.51 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $39.93 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $40.93 | ↓ -94% |
| Cigna | New Business ASO | $41.14 | ↓ -94% |
| Aetna | EBR FI | $45.98 | ↓ -94% |
| Aetna | EBR ASO | $48.40 | ↓ -93% |
| Cigna | Commercial | $48.40 | ↓ -93% |
| Coventry/First Health | Commercial | $53.24 | ↓ -93% |
| Highmark BCBS of PA | Managed Care | $55.54 | ↓ -92% |
| Highmark BCBS of PA | Managed Care - Social Mission | $55.54 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Indemnity | $57.72 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $57.72 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $60.50 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $60.50 | ↓ -92% |
| InterGroup | PPO | $60.50 | ↓ -92% |
| Cigna Behavioral Health | Commercial | $72.60 | ↓ -90% |
| Private Health Care Systems | PPO | $90.75 | ↓ -87% |
| American Healthcare Group | Commercial | $96.80 | ↓ -87% |
| InterGroup | Approved National Affiliated PPO Business | $96.80 | ↓ -87% |
| National Provider Network | PPO | $99.22 | ↓ -86% |
| Health Payors Organization | Commercial | $108.90 | ↓ -85% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $108.90 | ↓ -85% |
| UPMC Health Plan | Commercial | $680.10 | ↓ -6% |
| UPMC Health Plan | CHIP | $861.28 | ↑ +20% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Bravo | Medicare | not published by hospital | — |
Visitor-reported prices
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Stent bili dbl pgtl 10fx5cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $810.00 | $33.44 – $1,249.82 |
| UPMC Presbyterian | Pittsburgh | $3,092.40 | $14.52 – $1,392.54 |
| UPMC St. Margaret | Pittsburgh | $1,015.20 | $28.00 – $1,056.85 |
| UPMC Muncy | Muncy | $477.60 | $29.70 – $178.20 |
| UPMC Northwest | Seneca | $712.20 | $49.50 – $1,042.23 |
| UPMC Somerset | Somerset | $361.20 | $80.60 – $515.88 |
| UPMC Wellsboro | Wellsboro | $577.60 | $32.58 – $162.90 |
| UPMC Williamsport | Williamsport | $1,894.80 | $22.20 – $99.90 |