healthcosts.net
Tacrolimus 1 mg capsule, immediate-release at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$29.40
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.
$36.75
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.
$0.11 with UPMC Health Plan vs $22.07 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 | $0.11 | ↓ -100% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.17 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $0.17 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $0.17 | ↓ -99% |
| United Healthcare Community Plan for Families | PA Medicaid | $0.19 | ↓ -99% |
| UPMC Health Plan | Commercial | $0.21 | ↓ -99% |
| UPMC Health Plan | CHIP | $0.27 | ↓ -99% |
| Aetna | Medicare | $4.75 | ↓ -84% |
| Aetna | Neighborhood Network | $5.30 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $5.63 | ↓ -81% |
| Aetna | Home Depot Employer Group | $5.79 | ↓ -80% |
| Aetna | NBR ASO/FI | $5.89 | ↓ -80% |
| Cigna | New Business ASO | $6.46 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $6.60 | ↓ -78% |
| Bravo | Medicare | $6.65 | ↓ -77% |
| Aetna | EBR FI | $7.22 | ↓ -75% |
| Aetna | EBR ASO | $7.60 | ↓ -74% |
| Cigna | Commercial | $7.60 | ↓ -74% |
| Coventry/First Health | Commercial | $8.36 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicare | $9.50 | ↓ -68% |
| InterGroup | PPO | $9.50 | ↓ -68% |
| Cigna Behavioral Health | Commercial | $11.40 | ↓ -61% |
| Private Health Care Systems | PPO | $14.25 | ↓ -52% |
| American Healthcare Group | Commercial | $15.20 | ↓ -48% |
| InterGroup | Approved National Affiliated PPO Business | $15.20 | ↓ -48% |
| National Provider Network | PPO | $15.58 | ↓ -47% |
| Highmark BCBS of PA | Managed Care - Social Mission | $16.03 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $16.48 | ↓ -44% |
| Health Payors Organization | Commercial | $17.10 | ↓ -42% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $17.10 | ↓ -42% |
| Highmark BCBS of PA | Managed Care | $21.46 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Indemnity | $22.07 | ↓ -25% |
Visitor-reported prices
Comments
Tacrolimus 1 mg capsule, immediate-release at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $119.40 | $0.11 – $28.90 |
| UPMC Presbyterian | Pittsburgh | $91.80 | $0.11 – $38.25 |
| UPMC St. Margaret | Pittsburgh | $49.80 | $0.11 – $15.30 |
| UPMC Western Psychiatric | Pittsburgh | $91.80 | $0.17 – $38.25 |
| UPMC Muncy | Muncy | $27.60 | $0.17 – $15.30 |
| UPMC Northwest | Seneca | $42.80 | $0.11 – $30.60 |
| UPMC Somerset | Somerset | $21.00 | $0.17 – $5.58 |
| UPMC Wellsboro | Wellsboro | $27.60 | $0.17 – $15.30 |