healthcosts.net
Clozapine, 25 mg at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$18.60
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.
?
What you pay up front if you don't use insurance.
$31.00
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.
$0.27 with Health Partners Plans (Jefferson Health Plan) vs $19.68 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $0.27 | ↓ -99% |
| Aetna | CHIP/Medicaid | $1.57 | ↓ -92% |
| Aetna | Medicare | $2.19 | ↓ -88% |
| Highmark BCBS of PA | Medicare Advantage | $2.35 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $2.86 | ↓ -85% |
| Multiplan | Worker's Compensation | $3.33 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicare | $4.38 | ↓ -76% |
| Geisinger | Medicaid/CHIP | $4.81 | ↓ -74% |
| Preferred Healthcare System | PPO | $5.69 | ↓ -69% |
| Coventry/First Health | Commercial | $6.12 | ↓ -67% |
| Fidelis | Medicare | $6.56 | ↓ -65% |
| InterGroup | InterGroup Services Corporation | $6.56 | ↓ -65% |
| Health Coalition Partners | Intergroup | $7.00 | ↓ -62% |
| Multiplan | PPO | $7.00 | ↓ -62% |
| Private Health Care Systems | PPO | $7.00 | ↓ -62% |
| SelectCare | Commercial | $7.00 | ↓ -62% |
| Highmark BCBS of PA | Managed Care - Social Mission | $7.35 | ↓ -60% |
| Health Payors Organization | Commercial | $7.44 | ↓ -60% |
| Humana | Commercial | $7.44 | ↓ -60% |
| InterGroup | Approved National Affiliated PPO Business | $7.44 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7.55 | ↓ -59% |
| UPMC Health Plan | Commercial | $8.96 | ↓ -52% |
| Highmark BCBS of PA | Managed Care | $9.84 | ↓ -47% |
| Highmark BCBS of PA | Commercial - Indemnity | $10.12 | ↓ -46% |
| Highmark BCBS of PA | UPMC Emergent | $19.68 | ↑ +6% |
Visitor-reported prices
Comments
Clozapine, 25 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $5.40 | $0.31 – $4.38 |
| UPMC Passavant-McCandless | Pittsburgh | $18.60 | $0.28 – $8.05 |
| UPMC St. Margaret | Pittsburgh | $7.60 | $0.29 – $6.80 |
| UPMC Western Psychiatric | Pittsburgh | $18.60 | $2.19 – $7.44 |
| UPMC Muncy | Muncy | $8.40 | $0.98 – $5.85 |
| UPMC Northwest | Seneca | $17.40 | $0.28 – $6.71 |
| UPMC Wellsboro | Wellsboro | $8.40 | $0.27 – $5.85 |
| UPMC Williamsport | Williamsport | $8.40 | $1.75 – $5.85 |