healthcosts.net
Target gsa panel hmtlmph neop at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$1,353.00
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.
$2,255.00
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.
$279.00 with Aetna vs $4,924.81 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 |
|---|---|---|---|
| Aetna | Neighborhood Network | $279.00 | ↓ -79% |
| Aetna | Home Depot Employer Group | $304.50 | ↓ -77% |
| Aetna | NBR ASO/FI | $310.00 | ↓ -77% |
| Cigna | New Business ASO | $340.00 | ↓ -75% |
| Bravo | Medicare | $350.00 | ↓ -74% |
| Aetna | EBR FI | $380.00 | ↓ -72% |
| Cigna | Commercial | $400.00 | ↓ -70% |
| Aetna | EBR ASO | $400.00 | ↓ -70% |
| Coventry/First Health | Commercial | $440.00 | ↓ -67% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $453.10 | ↓ -67% |
| InterGroup | PPO | $500.00 | ↓ -63% |
| Cigna Behavioral Health | Commercial | $600.00 | ↓ -56% |
| UPMC Health Plan | Managed Medicare | $633.14 | ↓ -53% |
| UPMC Health Plan | Managed Medicaid | $668.38 | ↓ -51% |
| Highmark BCBS of PA | Managed Care - Social Mission | $684.28 | ↓ -49% |
| United Healthcare Community Plan for Families | PA Medicaid | $698.76 | ↓ -48% |
| Private Health Care Systems | PPO | $750.00 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $750.66 | ↓ -45% |
| Geisinger | Medicaid/CHIP | $759.53 | ↓ -44% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $779.43 | ↓ -42% |
| Aetna of PA | Medicare | $797.51 | ↓ -41% |
| InterGroup | Approved National Affiliated PPO Business | $800.00 | ↓ -41% |
| American Healthcare Group | Commercial | $800.00 | ↓ -41% |
| National Provider Network | PPO | $820.00 | ↓ -39% |
| AmeriHealth Caritas | Medicare | $820.29 | ↓ -39% |
| Highmark Wholecare (prev Gateway) | Medicare | $820.29 | ↓ -39% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $820.29 | ↓ -39% |
| Aetna | Medicare | $835.48 | ↓ -38% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $900.00 | ↓ -33% |
| Health Payors Organization | Commercial | $900.00 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicaid | $901.10 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $916.34 | ↓ -32% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $961.50 | ↓ -29% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,035.51 | ↓ -23% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,081.56 | ↓ -20% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,448.47 | ↑ +7% |
| UPMC Health Plan | Commercial | $3,182.48 | ↑ +135% |
| UPMC Health Plan | CHIP | $4,924.81 | ↑ +264% |
Visitor-reported prices
Comments
Target gsa panel hmtlmph neop at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,792.60 | $130.22 – $835.48 |
| UPMC Presbyterian | Pittsburgh | $3,169.80 | $457.42 – $945.88 |
| UPMC St. Margaret | Pittsburgh | $7,146.00 | $457.42 – $1,916.75 |
| UPMC Muncy | Muncy | $2,947.80 | $621.75 – $3,316.00 |
| UPMC Northwest | Seneca | $7,146.00 | $400.00 – $850.00 |
| UPMC Wellsboro | Wellsboro | $3,743.20 | $180.00 – $916.29 |
| UPMC Williamsport | Williamsport | $1,302.00 | $270.00 – $820.29 |