healthcosts.net
Ustekinumab 45 mg/0.5 ml subcutaneous solution at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
not published by hospital
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.
$514.02
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.
$124.54 with UPMC Health Plan vs $32,629.58 with United Healthcare Community Plan for Families — 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 Medicare | $124.54 | — |
| Aetna | Neighborhood Network | $143.41 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $153.31 | — |
| Aetna | Home Depot Employer Group | $156.52 | — |
| Aetna of PA | Medicare | $156.87 | — |
| Aetna | NBR ASO/FI | $159.35 | — |
| AmeriHealth Caritas | Medicare | $161.35 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $161.35 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $161.35 | — |
| Aetna | Medicare | $164.34 | — |
| Cigna | New Business ASO | $174.77 | — |
| UPMC Work Partners | Workers Comp | $178.52 | — |
| UPMC Health Plan | CHIP | $178.65 | — |
| Bravo | Medicare | $179.91 | — |
| Aetna | EBR FI | $195.33 | — |
| Cigna | Commercial | $205.61 | — |
| Aetna | EBR ASO | $205.61 | — |
| Coventry/First Health | Commercial | $226.17 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $230.34 | — |
| UPMC Health Plan | Commercial | $231.31 | — |
| InterGroup | PPO | $257.01 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $282.71 | — |
| Cigna Behavioral Health | Commercial | $308.41 | — |
| Private Health Care Systems | PPO | $385.51 | — |
| InterGroup | Approved National Affiliated PPO Business | $411.22 | — |
| American Healthcare Group | Commercial | $411.22 | — |
| National Provider Network | PPO | $421.50 | — |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $462.62 | — |
| Health Payors Organization | Commercial | $462.62 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $655.41 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $674.04 | — |
| Highmark BCBS of PA | Managed Care | $877.79 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $902.77 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $32,629.58 | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ustekinumab 45 mg/0.5 ml subcutaneous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $746.40 | $138.84 – $1,057.40 |
| UPMC St. Margaret | Pittsburgh | not published | $128.99 – $31,210.90 |
| UPMC Somerset | Somerset | $16,705.20 | $147.91 – $20,881.50 |
| UPMC Wellsboro | Wellsboro | $57.00 | $17.10 – $149.40 |
| UPMC Northwest | Seneca | not published | $135.49 – $29,792.22 |