healthcosts.net
Venous mech thrombectomy at UPMC Mercy
1400 Locust Street, Pittsburgh, PA · UPMC · · NPI 163914308
$12,268.80
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.
$20,448.00
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.
$4,626.06 with UPMC Health Plan vs $31,385.15 with Highmark BCBS of PA — 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 | Commercial | $4,626.06 | ↓ -62% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $5,066.59 | ↓ -59% |
| UPMC Work Partners | Workers Comp | $5,505.29 | ↓ -55% |
| Aetna | Neighborhood Network | $5,704.99 | ↓ -54% |
| Aetna | Home Depot Employer Group | $6,226.42 | ↓ -49% |
| Aetna | NBR ASO/FI | $6,338.88 | ↓ -48% |
| Cigna | New Business ASO | $6,952.32 | ↓ -43% |
| Bravo | Medicare | $7,156.80 | ↓ -42% |
| Aetna | EBR FI | $7,770.24 | ↓ -37% |
| Cigna | Commercial | $8,179.20 | ↓ -33% |
| Aetna | EBR ASO | $8,179.20 | ↓ -33% |
| UPMC Health Plan | CHIP | $8,368.64 | ↓ -32% |
| Coventry/First Health | Commercial | $8,997.12 | ↓ -27% |
| UPMC Health Plan | Managed Medicare | $9,012.77 | ↓ -27% |
| InterGroup | PPO | $10,224.00 | ↓ -17% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,095.14 | ↓ -10% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $11,246.40 | ↓ -8% |
| Aetna of PA | Medicare | $11,352.46 | ↓ -7% |
| Highmark BCBS of PA | Managed Care - Social Mission | $11,411.00 | ↓ -7% |
| AmeriHealth Caritas | Medicare | $11,676.82 | ↓ -5% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,676.82 | ↓ -5% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,676.82 | ↓ -5% |
| Aetna | Medicare | $11,893.06 | ↓ -3% |
| Cigna Behavioral Health | Commercial | $12,268.80 | ↑ +0% |
| Highmark BCBS of PA | Managed Care | $15,280.99 | ↑ +25% |
| Private Health Care Systems | PPO | $15,336.00 | ↑ +25% |
| InterGroup | Approved National Affiliated PPO Business | $16,358.40 | ↑ +33% |
| American Healthcare Group | Commercial | $16,358.40 | ↑ +33% |
| National Provider Network | PPO | $16,767.36 | ↑ +37% |
| Multiplan | PPO (inc. Auto and Worker's Compensation) | $18,403.20 | ↑ +50% |
| Health Payors Organization | Commercial | $18,403.20 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $23,435.55 | ↑ +91% |
| Highmark BCBS of PA | Commercial - Indemnity | $31,385.15 | ↑ +156% |
Visitor-reported prices
Comments
Venous mech thrombectomy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $26,215.20 | $4,574.16 – $37,138.20 |
| UPMC Presbyterian | Pittsburgh | $32,551.20 | $931.20 – $46,114.20 |
| UPMC Somerset | Somerset | $17,446.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $5,352.00 | $993.28 – $11,675.74 |