healthcosts.net
Stent iliac/open or perc/uni/init 37221 at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$21,521.40
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.
$35,869.00
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.
$468.05 with UPMC Health Plan vs $51,964.37 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 | $468.05 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $489.32 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $631.02 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $673.31 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $725.14 | ↓ -97% |
| UPMC Health Plan | Commercial | $7,162.48 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $7,768.47 | ↓ -64% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $8,388.75 | ↓ -61% |
| Aetna | Medicare | $8,967.25 | ↓ -58% |
| Aetna | Neighborhood Network | $10,007.45 | ↓ -54% |
| Aetna | Home Depot Employer Group | $10,922.11 | ↓ -49% |
| Aetna | NBR ASO/FI | $11,119.39 | ↓ -48% |
| UPMC Health Plan | CHIP | $11,400.37 | ↓ -47% |
| Cigna | New Business ASO | $12,195.46 | ↓ -43% |
| Bravo | Medicare | $12,554.15 | ↓ -42% |
| Aetna | EBR FI | $13,630.22 | ↓ -37% |
| Cigna | Commercial | $14,347.60 | ↓ -33% |
| Aetna | EBR ASO | $14,347.60 | ↓ -33% |
| Coventry/First Health | Commercial | $15,782.36 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $17,934.50 | ↓ -17% |
| InterGroup | PPO | $17,934.50 | ↓ -17% |
| Highmark BCBS of PA | Managed Care - Social Mission | $18,893.18 | ↓ -12% |
| Cigna Behavioral Health | Commercial | $21,521.40 | ↑ +0% |
| Highmark BCBS of PA | Managed Care | $25,300.72 | ↑ +18% |
| Private Health Care Systems | PPO | $26,901.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $28,695.20 | ↑ +33% |
| American Healthcare Group | Commercial | $28,695.20 | ↑ +33% |
| National Provider Network | PPO | $29,412.58 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $32,282.10 | ↑ +50% |
| Health Payors Organization | Commercial | $32,282.10 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $38,802.24 | ↑ +80% |
| Highmark BCBS of PA | Commercial - Indemnity | $51,964.37 | ↑ +141% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Stent iliac/open or perc/uni/init 37221 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $33,589.20 | $5,152.97 – $47,584.70 |
| UPMC Presbyterian | Pittsburgh | $32,172.60 | $468.05 – $45,577.85 |
| UPMC St. Margaret | Pittsburgh | $17,448.00 | $5,116.53 – $24,718.00 |
| UPMC Northwest | Seneca | $21,381.00 | $5,385.45 – $30,289.75 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $6,724.80 | $993.28 – $11,675.74 |