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Cyclophosphamide 25 mg capsule at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$133.20
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.
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What you pay up front if you don't use insurance.
$222.00
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.
$0.69 with UPMC Health Plan vs $93.50 with InterGroup — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $0.69 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1.00 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1.10 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $1.10 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1.10 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1.10 | ↓ -99% |
| UPMC Health Plan | Commercial | $1.35 | ↓ -99% |
| Highmark BCBS of PA | Medicare Advantage | $3.79 | ↓ -97% |
| Highmark BCBS of PA | Managed Care - Social Mission | $7.40 | ↓ -94% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7.62 | ↓ -94% |
| Highmark BCBS of PA | Managed Care | $9.92 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Indemnity | $10.20 | ↓ -92% |
| Aetna | CHIP/Medicaid | $19.80 | ↓ -85% |
| Highmark BCBS of PA | UPMC Emergent | $19.83 | ↓ -85% |
| Aetna | Medicare | $27.50 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $35.95 | ↓ -73% |
| Multiplan | Worker's Compensation | $41.80 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $55.00 | ↓ -59% |
| Preferred Healthcare System | PPO | $71.50 | ↓ -46% |
| Coventry/First Health | Commercial | $77.00 | ↓ -42% |
| Fidelis | Medicare | $82.50 | ↓ -38% |
| InterGroup | InterGroup Services Corporation | $82.50 | ↓ -38% |
| Health Coalition Partners | Intergroup | $88.00 | ↓ -34% |
| Multiplan | PPO | $88.00 | ↓ -34% |
| Private Health Care Systems | PPO | $88.00 | ↓ -34% |
| SelectCare | Commercial | $88.00 | ↓ -34% |
| Health Payors Organization | Commercial | $93.50 | ↓ -30% |
| Humana | Commercial | $93.50 | ↓ -30% |
| InterGroup | Approved National Affiliated PPO Business | $93.50 | ↓ -30% |
Visitor-reported prices
Comments
Cyclophosphamide 25 mg capsule at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $28.20 | $0.69 – $18.90 |
| UPMC Passavant-McCandless | Pittsburgh | $67.20 | $0.69 – $11.90 |
| UPMC St. Margaret | Pittsburgh | $30.60 | $0.69 – $10.20 |
| UPMC Western Psychiatric | Pittsburgh | $67.20 | $1.10 – $95.20 |
| UPMC Muncy | Muncy | $43.20 | $1.10 – $64.80 |
| UPMC Somerset | Somerset | $7.80 | $0.72 – $3.72 |
| UPMC Wellsboro | Wellsboro | $43.20 | $1.10 – $64.80 |