healthcosts.net
Crotalidae poly immune fab at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$6,805.20
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.
$11,342.00
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.
$1,154.65 with UPMC Health Plan vs $24,991.51 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $1,154.65 | ↓ -83% |
| Geisinger | Medicaid/CHIP | $1,828.71 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1,828.71 | ↓ -73% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,828.71 | ↓ -73% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,828.71 | ↓ -73% |
| Aetna | CHIP/Medicaid | $1,938.44 | ↓ -72% |
| AmeriHealth Caritas | Medicare | $1,975.02 | ↓ -71% |
| United Healthcare | Medicare | $1,975.02 | ↓ -71% |
| Cigna Lifesource | Medicare Transplant | $1,975.02 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,975.02 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,975.02 | ↓ -71% |
| Aetna | Medicare | $2,011.59 | ↓ -70% |
| Aetna of PA | Medicare | $2,011.59 | ↓ -70% |
| UPMC Health Plan | Commercial | $2,249.32 | ↓ -67% |
| Highmark BCBS of PA | Medicare Advantage | $2,979.26 | ↓ -56% |
| UPMC Work Partners | Workers Comp | $3,644.47 | ↓ -46% |
| Multiplan | Worker's Compensation | $4,237.76 | ↓ -38% |
| Preferred Healthcare System | PPO | $7,248.80 | ↑ +7% |
| Coventry/First Health | Commercial | $7,806.40 | ↑ +15% |
| Fidelis | Medicare | $8,364.00 | ↑ +23% |
| InterGroup | InterGroup Services Corporation | $8,364.00 | ↑ +23% |
| Health Coalition Partners | Intergroup | $8,921.60 | ↑ +31% |
| Private Health Care Systems | PPO | $8,921.60 | ↑ +31% |
| SelectCare | Commercial | $8,921.60 | ↑ +31% |
| Multiplan | PPO | $8,921.60 | ↑ +31% |
| Highmark BCBS of PA | Managed Care - Social Mission | $9,330.10 | ↑ +37% |
| InterGroup | Approved National Affiliated PPO Business | $9,479.20 | ↑ +39% |
| Health Payors Organization | Commercial | $9,479.20 | ↑ +39% |
| Humana | Commercial | $9,479.20 | ↑ +39% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $9,595.40 | ↑ +41% |
| Highmark BCBS of PA | Managed Care | $12,495.76 | ↑ +84% |
| Highmark BCBS of PA | Commercial - Indemnity | $12,851.08 | ↑ +89% |
| Highmark BCBS of PA | UPMC Emergent | $24,991.51 | ↑ +267% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Crotalidae poly immune fab at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | not published | $1,154.65 – $6,392.08 |
| UPMC St. Margaret | Pittsburgh | not published | $1,154.65 – $6,036.96 |
| UPMC Muncy | Muncy | $14,450.40 | $1,828.71 – $21,675.60 |
| UPMC Wellsboro | Wellsboro | $14,450.40 | $1,828.71 – $21,675.60 |
| UPMC Williamsport | Williamsport | $6,069.00 | $1,828.71 – $9,103.50 |
| UPMC Northwest | Seneca | not published | $1,154.65 – $6,036.96 |