Composite drsg >16<=48 sq in at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$6.00
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.
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What you pay up front if you don't use insurance.
$10.00
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.
$1.80 with Aetna vs $56.32 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 | $1.80 | ↓ -70% |
| Aetna | Medicare | $2.50 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicare | $5.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $5.50 | ↓ -8% |
| Preferred Healthcare System | PPO | $6.50 | ↑ +8% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $6.73 | ↑ +12% |
| Coventry/First Health | Commercial | $7.00 | ↑ +17% |
| Fidelis | Medicare | $7.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $7.50 | ↑ +25% |
| Private Health Care Systems | PPO | $8.00 | ↑ +33% |
| Multiplan | PPO | $8.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $8.00 | ↑ +33% |
| SelectCare | Commercial | $8.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $8.50 | ↑ +42% |
| Humana | Commercial | $8.50 | ↑ +42% |
| Health Payors Organization | Commercial | $8.50 | ↑ +42% |
| Highmark BCBS of PA | Medicare Advantage | $11.15 | ↑ +86% |
| UPMC Work Partners | Workers Comp | $14.32 | ↑ +139% |
| Multiplan | Worker's Compensation | $16.65 | ↑ +178% |
| Highmark BCBS of PA | Managed Care - Social Mission | $18.53 | ↑ +209% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $18.86 | ↑ +214% |
| Highmark BCBS of PA | Managed Care | $24.81 | ↑ +314% |
| Highmark BCBS of PA | Commercial - Indemnity | $25.26 | ↑ +321% |
| Highmark BCBS of PA | UPMC Emergent | $49.62 | ↑ +727% |
| UPMC Health Plan | Commercial | $56.32 | ↑ +839% |
Visitor-reported prices
Comments
Composite drsg >16<=48 sq in at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $4.80 | $5.86 – $34.83 |
| UPMC Mercy | Pittsburgh | $3.60 | $11.04 – $27.50 |
| UPMC Passavant-McCandless | Pittsburgh | $4.80 | $11.15 – $50.55 |
| UPMC St. Margaret | Pittsburgh | $43.20 | $11.15 – $42.74 |
| UPMC East | Monroeville | $4.20 | $1.75 – $34.83 |
| UPMC Northwest | Seneca | $42.60 | $14.32 – $42.15 |
| UPMC Wellsboro | Wellsboro | $5.40 | $7.18 – $14.32 |