healthcosts.net
Apl(pml-rara) quant - sendout at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$765.00
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.
$1,275.00
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.
$204.89 with UPMC Work Partners vs $1,717.21 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 Work Partners | Workers Comp | $204.89 | ↓ -73% |
| AmeriHealth Caritas | Medicare | $223.89 | ↓ -71% |
| United Healthcare | Medicare | $223.89 | ↓ -71% |
| Cigna Lifesource | Medicare Transplant | $223.89 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $223.89 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $223.89 | ↓ -71% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $226.26 | ↓ -70% |
| Aetna | Medicare | $228.04 | ↓ -70% |
| Aetna of PA | Medicare | $228.04 | ↓ -70% |
| Multiplan | Worker's Compensation | $238.24 | ↓ -69% |
| UPMC Health Plan | Commercial | $245.33 | ↓ -68% |
| UPMC Health Plan | Managed Medicaid | $248.89 | ↓ -67% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $271.51 | ↓ -65% |
| Aetna | CHIP/Medicaid | $294.14 | ↓ -62% |
| Highmark Wholecare (prev Gateway) | Medicaid | $335.54 | ↓ -56% |
| Geisinger | Medicaid/CHIP | $352.22 | ↓ -54% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $358.03 | ↓ -53% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $385.59 | ↓ -50% |
| Highmark BCBS of PA | Medicare Advantage | $385.73 | ↓ -50% |
| Highmark BCBS of PA | Managed Care - Social Mission | $641.16 | ↓ -16% |
| Preferred Healthcare System | PPO | $737.75 | ↓ -4% |
| Coventry/First Health | Commercial | $794.50 | ↑ +4% |
| Fidelis | Medicare | $851.25 | ↑ +11% |
| InterGroup | InterGroup Services Corporation | $851.25 | ↑ +11% |
| Highmark BCBS of PA | Managed Care | $858.60 | ↑ +12% |
| Health Coalition Partners | Intergroup | $908.00 | ↑ +19% |
| Private Health Care Systems | PPO | $908.00 | ↑ +19% |
| SelectCare | Commercial | $908.00 | ↑ +19% |
| Multiplan | PPO | $908.00 | ↑ +19% |
| InterGroup | Approved National Affiliated PPO Business | $964.75 | ↑ +26% |
| Health Payors Organization | Commercial | $964.75 | ↑ +26% |
| Humana | Commercial | $964.75 | ↑ +26% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,013.41 | ↑ +32% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,357.19 | ↑ +77% |
| Highmark BCBS of PA | UPMC Emergent | $1,717.21 | ↑ +124% |
Visitor-reported prices
Comments
Apl(pml-rara) quant - sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,812.60 | $192.65 – $964.75 |
| UPMC Northwest | Seneca | $2,235.60 | $188.01 – $3,167.10 |
| UPMC Wellsboro | Wellsboro | $503.20 | $113.22 – $566.10 |
| UPMC Williamsport | Williamsport | $741.00 | $204.89 – $560.00 |