healthcosts.net
Thrombectomy/inf pq dialysis circuit w/pta at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$5,811.60
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.
?
What you pay up front if you don't use insurance.
$9,686.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$386.68 with UPMC Health Plan vs $11,893.06 with Aetna — 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 →
?
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 | $386.68 | ↓ -93% |
| United Healthcare Community Plan for Families | PA Medicaid | $404.26 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $521.32 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $556.26 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $599.08 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,409.77 | ↓ -76% |
| Aetna | Neighborhood Network | $2,702.39 | ↓ -54% |
| Aetna | Home Depot Employer Group | $2,949.39 | ↓ -49% |
| Aetna | NBR ASO/FI | $3,002.66 | ↓ -48% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,175.09 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $3,270.18 | ↓ -44% |
| Cigna | New Business ASO | $3,293.24 | ↓ -43% |
| UPMC Health Plan | CHIP | $3,390.10 | ↓ -42% |
| Bravo | Medicare | $3,390.10 | ↓ -42% |
| Aetna | EBR FI | $3,680.68 | ↓ -37% |
| Cigna | Commercial | $3,874.40 | ↓ -33% |
| Aetna | EBR ASO | $3,874.40 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $4,251.91 | ↓ -27% |
| Coventry/First Health | Commercial | $4,261.84 | ↓ -27% |
| UPMC Health Plan | Commercial | $4,358.70 | ↓ -25% |
| InterGroup | PPO | $4,843.00 | ↓ -17% |
| Cigna Behavioral Health | Commercial | $5,811.60 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6,520.91 | ↑ +12% |
| Private Health Care Systems | PPO | $7,264.50 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $7,748.80 | ↑ +33% |
| American Healthcare Group | Commercial | $7,748.80 | ↑ +33% |
| National Provider Network | PPO | $7,942.52 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $8,717.40 | ↑ +50% |
| Health Payors Organization | Commercial | $8,717.40 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Indemnity | $8,732.87 | ↑ +50% |
| UPMC Health Plan | Managed Medicare | $9,012.77 | ↑ +55% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,095.14 | ↑ +91% |
| Aetna of PA | Medicare | $11,352.46 | ↑ +95% |
| AmeriHealth Caritas | Medicare | $11,676.82 | ↑ +101% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,676.82 | ↑ +101% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,676.82 | ↑ +101% |
| Aetna | Medicare | $11,893.06 | ↑ +105% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Thrombectomy/inf pq dialysis circuit w/pta at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $8,026.20 | $386.68 – $11,893.06 |
| UPMC Presbyterian | Pittsburgh | $11,800.20 | $386.68 – $16,716.95 |
| UPMC St. Margaret | Pittsburgh | $6,277.20 | $386.68 – $11,352.46 |
| UPMC Somerset | Somerset | $24,300.00 | $386.68 – $30,375.00 |
| UPMC Williamsport | Williamsport | $3,903.00 | $386.68 – $5,204.00 |