healthcosts.net
Cdna analysis for variants at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2,009.40
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.
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What you pay up front if you don't use insurance.
$3,349.00
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.
$70.74 with Aetna vs $2,060.72 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $70.74 | ↓ -96% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $135.56 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $183.04 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $200.02 | ↓ -90% |
| Cigna Lifesource | Medicare Transplant | $200.02 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $200.02 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $200.02 | ↓ -90% |
| United Healthcare | Medicare | $200.02 | ↓ -90% |
| Aetna | Medicare | $203.72 | ↓ -90% |
| Aetna of PA | Medicare | $203.72 | ↓ -90% |
| Multiplan | Worker's Compensation | $212.84 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $216.15 | ↓ -89% |
| Preferred Healthcare System | PPO | $255.45 | ↓ -87% |
| Coventry/First Health | Commercial | $275.10 | ↓ -86% |
| UPMC Health Plan | Commercial | $286.39 | ↓ -86% |
| Fidelis | Medicare | $294.75 | ↓ -85% |
| InterGroup | InterGroup Services Corporation | $294.75 | ↓ -85% |
| Health Coalition Partners | Intergroup | $314.40 | ↓ -84% |
| Multiplan | PPO | $314.40 | ↓ -84% |
| Private Health Care Systems | PPO | $314.40 | ↓ -84% |
| SelectCare | Commercial | $314.40 | ↓ -84% |
| Health Payors Organization | Commercial | $334.05 | ↓ -83% |
| Humana | Commercial | $334.05 | ↓ -83% |
| InterGroup | Approved National Affiliated PPO Business | $334.05 | ↓ -83% |
| Highmark BCBS of PA | Medicare Advantage | $462.90 | ↓ -77% |
| Highmark BCBS of PA | Managed Care - Social Mission | $769.42 | ↓ -62% |
| Highmark BCBS of PA | Managed Care | $1,030.36 | ↓ -49% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,216.13 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,628.68 | ↓ -19% |
| Highmark BCBS of PA | UPMC Emergent | $2,060.72 | ↑ +3% |
Visitor-reported prices
Comments
Cdna analysis for variants at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,118.00 | $141.78 – $462.90 |
| UPMC Mercy | Pittsburgh | $2,009.40 | $154.38 – $916.20 |
| UPMC St. Margaret | Pittsburgh | $2,008.20 | $159.90 – $850.00 |
| UPMC Muncy | Muncy | $1,792.80 | $144.60 – $948.00 |
| UPMC Northwest | Seneca | $7,041.00 | $167.96 – $486.20 |
| UPMC Somerset | Somerset | $1,070.40 | $129.92 – $1,338.00 |
| UPMC Wellsboro | Wellsboro | $2,276.80 | $96.12 – $480.60 |
| UPMC Williamsport | Williamsport | $1,934.40 | $144.60 – $633.60 |