Contact layer >16<= 48 sq in at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$24.00
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.
$40.00
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.
$5.94 with Aetna vs $66.37 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 | $5.94 | ↓ -75% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $7.93 | ↓ -67% |
| Aetna | Medicare | $8.25 | ↓ -66% |
| Highmark BCBS of PA | Medicare Advantage | $13.14 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicare | $16.50 | ↓ -31% |
| UPMC Work Partners | Workers Comp | $16.86 | ↓ -30% |
| Geisinger | Medicaid/CHIP | $18.15 | ↓ -24% |
| Multiplan | Worker's Compensation | $19.61 | ↓ -18% |
| Preferred Healthcare System | PPO | $21.45 | ↓ -11% |
| Highmark BCBS of PA | Managed Care - Social Mission | $21.83 | ↓ -9% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $22.23 | ↓ -7% |
| Coventry/First Health | Commercial | $23.10 | ↓ -4% |
| Fidelis | Medicare | $24.75 | ↑ +3% |
| InterGroup | InterGroup Services Corporation | $24.75 | ↑ +3% |
| SelectCare | Commercial | $26.40 | ↑ +10% |
| Private Health Care Systems | PPO | $26.40 | ↑ +10% |
| Multiplan | PPO | $26.40 | ↑ +10% |
| Health Coalition Partners | Intergroup | $26.40 | ↑ +10% |
| InterGroup | Approved National Affiliated PPO Business | $28.05 | ↑ +17% |
| Humana | Commercial | $28.05 | ↑ +17% |
| Health Payors Organization | Commercial | $28.05 | ↑ +17% |
| Highmark BCBS of PA | Managed Care | $29.24 | ↑ +22% |
| Highmark BCBS of PA | Commercial - Indemnity | $29.77 | ↑ +24% |
| Highmark BCBS of PA | UPMC Emergent | $58.48 | ↑ +144% |
| UPMC Health Plan | Commercial | $66.37 | ↑ +177% |
Visitor-reported prices
Comments
Contact layer >16<= 48 sq in at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3.00 | $2.50 – $41.05 |