healthcosts.net

Support clav 29.6-40.5in med at UPMC Mercy

1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

$129.60

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.

Full explanation →

What you pay up front if you don't use insurance.

$216.00

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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$51.84 with Highmark Wholecare (prev Gateway) vs $299.94 with UPMC Health Plan — same scan, same building. Share

Negotiated rates by payer
?

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 $51.84 ↓ -60%
Aetna Medicare $54.00 ↓ -58%
Aetna Neighborhood Network $60.26 ↓ -54%
Aetna Home Depot Employer Group $65.77 ↓ -49%
Aetna NBR ASO/FI $66.96 ↓ -48%
Cigna New Business ASO $73.44 ↓ -43%
Highmark BCBS of PA Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage $80.56 ↓ -38%
Aetna EBR FI $82.08 ↓ -37%
Aetna EBR ASO $86.40 ↓ -33%
Cigna Commercial $86.40 ↓ -33%
Coventry/First Health Commercial $95.04 ↓ -27%
Highmark Wholecare (prev Gateway) Medicare $108.00 ↓ -17%
InterGroup PPO $108.00 ↓ -17%
UPMC Work Partners Workers Comp $114.97 ↓ -11%
PA Health & Wellness Community Health Choices/PA Medicaid HMO $118.80 ↓ -8%
Highmark BCBS of PA Managed Care - Social Mission $121.66 ↓ -6%
Highmark BCBS of PA Commercial - Social Mission Indemnity $123.87 ↓ -4%
Cigna Behavioral Health Commercial $129.60 ↑ +0%
Private Health Care Systems PPO $162.00 ↑ +25%
Highmark BCBS of PA Managed Care $162.92 ↑ +26%
Highmark BCBS of PA Commercial - Indemnity $165.88 ↑ +28%
American Healthcare Group Commercial $172.80 ↑ +33%
InterGroup Approved National Affiliated PPO Business $172.80 ↑ +33%
National Provider Network PPO $177.12 ↑ +37%
Health Payors Organization Commercial $194.40 ↑ +50%
Multiplan PPO (inc. Auto and Worker's Compensation) $194.40 ↑ +50%
UPMC Health Plan Commercial $236.84 ↑ +83%
UPMC Health Plan CHIP $299.94 ↑ +131%
Bravo Medicare not published by hospital

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Support clav 29.6-40.5in med at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Passavant-McCandless Pittsburgh $137.40 $50.38 – $435.24
UPMC Presbyterian Pittsburgh $133.20 $26.64 – $484.94
UPMC St. Margaret Pittsburgh $131.40 $43.80 – $368.04
UPMC Muncy Muncy $180.60 $45.15 – $240.80
UPMC Northwest Seneca $165.00 $68.75 – $362.95
UPMC Wellsboro Wellsboro $218.40 $49.14 – $245.70
UPMC Williamsport Williamsport $180.60 $60.20 – $240.80

All Pennsylvania hospitals for this procedure →