healthcosts.net
Ultrasound joint complete left at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$785.40
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.
?
What you pay up front if you don't use insurance.
$1,309.00
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.
$84.51 with UPMC Health Plan vs $1,178.10 with Health Payors Organization — 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 Medicare | $84.51 | ↓ -89% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $104.04 | ↓ -87% |
| Aetna of PA | Medicare | $106.45 | ↓ -86% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.49 | ↓ -86% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -86% |
| Aetna | Medicare | $111.52 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $153.76 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $189.78 | ↓ -76% |
| UPMC Health Plan | Commercial | $273.28 | ↓ -65% |
| Bravo | Medicare | $327.25 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $346.30 | ↓ -56% |
| Aetna | Neighborhood Network | $365.21 | ↓ -54% |
| Aetna | Home Depot Employer Group | $398.59 | ↓ -49% |
| Aetna | NBR ASO/FI | $405.79 | ↓ -48% |
| Cigna | New Business ASO | $445.06 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $463.74 | ↓ -41% |
| Aetna | EBR FI | $497.42 | ↓ -37% |
| Cigna | Commercial | $523.60 | ↓ -33% |
| Aetna | EBR ASO | $523.60 | ↓ -33% |
| UPMC Health Plan | CHIP | $550.20 | ↓ -30% |
| Coventry/First Health | Commercial | $575.96 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $653.17 | ↓ -17% |
| InterGroup | PPO | $654.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $719.95 | ↓ -8% |
| Cigna Behavioral Health | Commercial | $785.40 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity | $874.77 | ↑ +11% |
| Private Health Care Systems | PPO | $981.75 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $1,047.20 | ↑ +33% |
| American Healthcare Group | Commercial | $1,047.20 | ↑ +33% |
| National Provider Network | PPO | $1,073.38 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $1,178.10 | ↑ +50% |
| Health Payors Organization | Commercial | $1,178.10 | ↑ +50% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ultrasound joint complete left at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $965.40 | $94.21 – $1,367.65 |
| UPMC Presbyterian | Pittsburgh | $1,263.00 | $79.42 – $1,789.25 |
| UPMC St. Margaret | Pittsburgh | $925.20 | $87.53 – $1,310.70 |
| UPMC Muncy | Muncy | $847.80 | $84.71 – $1,130.40 |
| UPMC Northwest | Seneca | $625.80 | $91.94 – $886.55 |
| UPMC Somerset | Somerset | $394.20 | $76.11 – $492.75 |
| UPMC Wellsboro | Wellsboro | $1,025.60 | $84.71 – $1,153.80 |
| UPMC Williamsport | Williamsport | $847.80 | $84.71 – $1,130.40 |