healthcosts.net
Closed treatment of femoral fracture proximal end neck; wi at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$7,860.60
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.
$13,101.00
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.
$412.20 with United Healthcare Community Plan for Families vs $23,214.77 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $412.20 | ↓ -95% |
| Highmark BCBS of PA | Medicare Advantage | $1,321.43 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $2,192.78 | ↓ -72% |
| Aetna | CHIP/Medicaid | $2,358.18 | ↓ -70% |
| Multiplan | Worker's Compensation | $2,549.75 | ↓ -68% |
| Aetna | Medicare | $3,275.25 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,275.66 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $4,386.53 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,550.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6,727.36 | ↓ -14% |
| Geisinger | Medicaid/CHIP | $7,205.55 | ↓ -8% |
| Preferred Healthcare System | PPO | $8,515.65 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $8,773.06 | ↑ +12% |
| Highmark BCBS of PA | Commercial - Indemnity | $9,009.39 | ↑ +15% |
| Coventry/First Health | Commercial | $9,170.70 | ↑ +17% |
| Fidelis | Medicare | $9,825.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $9,825.75 | ↑ +25% |
| Health Coalition Partners | Intergroup | $10,480.80 | ↑ +33% |
| Multiplan | PPO | $10,480.80 | ↑ +33% |
| Private Health Care Systems | PPO | $10,480.80 | ↑ +33% |
| SelectCare | Commercial | $10,480.80 | ↑ +33% |
| Health Payors Organization | Commercial | $11,135.85 | ↑ +42% |
| Humana | Commercial | $11,135.85 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $11,135.85 | ↑ +42% |
| UPMC Health Plan | Commercial | $23,214.77 | ↑ +195% |
Visitor-reported prices
Comments
Closed treatment of femoral fracture proximal end neck; wi at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,279.60 | $1,308.97 – $4,919.40 |
| UPMC St. Margaret | Pittsburgh | $7,328.40 | $1,321.43 – $10,381.90 |
| UPMC Muncy | Muncy | $3,001.80 | $439.68 – $4,002.40 |
| UPMC Wellsboro | Wellsboro | $3,630.40 | $439.68 – $4,084.20 |
| UPMC Williamsport | Williamsport | $3,001.80 | $439.68 – $4,002.40 |