healthcosts.net
Vaccine tdap >=7 years im at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$42.40
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.
$53.00
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.
$11.00 with UPMC Health Plan vs $289.66 with Highmark BCBS of PA — 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 | $11.00 | ↓ -74% |
| United Healthcare Community Plan for Families | PA Medicaid | $11.50 | ↓ -73% |
| Aetna | Medicare | $13.25 | ↓ -69% |
| Aetna | Neighborhood Network | $14.79 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.83 | ↓ -65% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.82 | ↓ -63% |
| Aetna | Home Depot Employer Group | $16.14 | ↓ -62% |
| Aetna | NBR ASO/FI | $16.43 | ↓ -61% |
| Cigna | New Business ASO | $18.02 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $18.41 | ↓ -57% |
| Bravo | Medicare | $18.55 | ↓ -56% |
| Aetna | EBR FI | $20.14 | ↓ -53% |
| Cigna | Commercial | $21.20 | ↓ -50% |
| Aetna | EBR ASO | $21.20 | ↓ -50% |
| Coventry/First Health | Commercial | $23.32 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicare | $26.50 | ↓ -38% |
| InterGroup | PPO | $26.50 | ↓ -38% |
| Cigna Behavioral Health | Commercial | $31.80 | ↓ -25% |
| Private Health Care Systems | PPO | $39.75 | ↓ -6% |
| Geisinger | Medicaid/CHIP | $39.81 | ↓ -6% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $39.81 | ↓ -6% |
| InterGroup | Approved National Affiliated PPO Business | $42.40 | ↑ +0% |
| American Healthcare Group | Commercial | $42.40 | ↑ +0% |
| National Provider Network | PPO | $43.46 | ↑ +3% |
| UPMC Health Plan | CHIP | $44.45 | ↑ +5% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $47.70 | ↑ +13% |
| Health Payors Organization | Commercial | $47.70 | ↑ +13% |
| UPMC Health Plan | Commercial | $48.97 | ↑ +15% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $73.91 | ↑ +74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $210.29 | ↑ +396% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $216.27 | ↑ +410% |
| Highmark BCBS of PA | Managed Care | $281.64 | ↑ +564% |
| Highmark BCBS of PA | Commercial - Indemnity | $289.66 | ↑ +583% |
Visitor-reported prices
Comments
Vaccine tdap >=7 years im at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $31.80 | $11.00 – $74.61 |
| UPMC Presbyterian | Pittsburgh | $33.60 | $11.00 – $74.61 |
| UPMC St. Margaret | Pittsburgh | $42.40 | $11.00 – $74.61 |
| UPMC Western Psychiatric | Pittsburgh | $31.80 | $13.25 – $73.11 |
| UPMC Muncy | Muncy | $42.40 | $7.95 – $47.70 |
| UPMC Northwest | Seneca | $42.40 | $11.00 – $191.81 |
| UPMC Somerset | Somerset | $54.00 | $11.00 – $73.16 |
| UPMC Wellsboro | Wellsboro | $42.40 | $9.54 – $47.70 |