healthcosts.net
Bln 30frx10mmx12cm renal nephromax at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$6,414.60
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.
$10,691.00
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.
$48.42 with Aetna vs $2,051.95 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $48.42 | ↓ -99% |
| Aetna | Medicare | $67.25 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $99.12 | ↓ -98% |
| Highmark BCBS of PA | Medicare Advantage | $134.50 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicare | $134.50 | ↓ -98% |
| Highmark BCBS of PA | Managed Care | $137.19 | ↓ -98% |
| Highmark BCBS of PA | Managed Care - Social Mission | $137.19 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Indemnity | $142.57 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $142.57 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $147.95 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $156.94 | ↓ -98% |
| Preferred Healthcare System | PPO | $174.85 | ↓ -97% |
| Coventry/First Health | Commercial | $188.30 | ↓ -97% |
| Fidelis | Medicare | $201.75 | ↓ -97% |
| InterGroup | InterGroup Services Corporation | $201.75 | ↓ -97% |
| Health Coalition Partners | Intergroup | $215.20 | ↓ -97% |
| Multiplan | PPO | $215.20 | ↓ -97% |
| Private Health Care Systems | PPO | $215.20 | ↓ -97% |
| SelectCare | Commercial | $215.20 | ↓ -97% |
| Health Payors Organization | Commercial | $228.65 | ↓ -96% |
| Humana | Commercial | $228.65 | ↓ -96% |
| InterGroup | Approved National Affiliated PPO Business | $228.65 | ↓ -96% |
| Highmark BCBS of PA | UPMC Emergent | $274.38 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $279.44 | ↓ -96% |
| Aetna | First Health | $413.00 | ↓ -94% |
| UPMC Health Plan | Commercial | $2,051.95 | ↓ -68% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Bln 30frx10mmx12cm renal nephromax at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $5,428.20 | $57.50 – $1,002.16 |
| UPMC Passavant-McCandless | Pittsburgh | $1,429.80 | $65.25 – $1,841.66 |
| UPMC St. Margaret | Pittsburgh | $3,997.20 | $61.50 – $1,557.31 |
| UPMC Muncy | Muncy | $4,790.40 | $52.95 – $317.70 |
| UPMC Northwest | Seneca | $752.40 | $182.25 – $1,535.76 |
| UPMC Somerset | Somerset | $661.80 | $369.78 – $760.16 |
| UPMC Wellsboro | Wellsboro | $5,793.60 | $39.06 – $195.30 |
| UPMC Williamsport | Williamsport | $4,790.40 | $19.00 – $85.50 |