healthcosts.net
Cystic fibrosis cftr at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$4,054.80
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.
$6,758.00
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.
$399.20 with Health Partners Plans (Jefferson Health Plan) vs $9,450.24 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $399.20 | ↓ -90% |
| UPMC Health Plan | Managed Medicaid | $439.12 | ↓ -89% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $479.04 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $493.18 | ↓ -88% |
| Aetna | CHIP/Medicaid | $518.96 | ↓ -87% |
| AmeriHealth Caritas | Medicare | $538.92 | ↓ -87% |
| United Healthcare | Medicare | $538.92 | ↓ -87% |
| Cigna Lifesource | Medicare Transplant | $538.92 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicare | $538.92 | ↓ -87% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $538.92 | ↓ -87% |
| Aetna | Medicare | $548.90 | ↓ -86% |
| Aetna of PA | Medicare | $548.90 | ↓ -86% |
| Multiplan | Worker's Compensation | $573.46 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $592.01 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $621.43 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $631.69 | ↓ -84% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $680.32 | ↓ -83% |
| Highmark BCBS of PA | Medicare Advantage | $2,122.79 | ↓ -48% |
| UPMC Health Plan | Commercial | $2,346.38 | ↓ -42% |
| Preferred Healthcare System | PPO | $3,252.60 | ↓ -20% |
| Coventry/First Health | Commercial | $3,502.80 | ↓ -14% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,528.48 | ↓ -13% |
| Fidelis | Medicare | $3,753.00 | ↓ -7% |
| InterGroup | InterGroup Services Corporation | $3,753.00 | ↓ -7% |
| Health Coalition Partners | Intergroup | $4,003.20 | ↓ -1% |
| Private Health Care Systems | PPO | $4,003.20 | ↓ -1% |
| SelectCare | Commercial | $4,003.20 | ↓ -1% |
| Multiplan | PPO | $4,003.20 | ↓ -1% |
| InterGroup | Approved National Affiliated PPO Business | $4,253.40 | ↑ +5% |
| Health Payors Organization | Commercial | $4,253.40 | ↑ +5% |
| Humana | Commercial | $4,253.40 | ↑ +5% |
| Highmark BCBS of PA | Managed Care | $4,725.12 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,577.06 | ↑ +38% |
| Highmark BCBS of PA | Commercial - Indemnity | $7,468.97 | ↑ +84% |
| Highmark BCBS of PA | UPMC Emergent | $9,450.24 | ↑ +133% |
Visitor-reported prices
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Cystic fibrosis cftr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $6,408.00 | $439.12 – $9,076.30 |
| UPMC Mercy | Pittsburgh | $4,054.80 | $415.97 – $6,082.20 |
| UPMC Muncy | Muncy | $3,474.60 | $439.12 – $4,632.80 |
| UPMC Wellsboro | Wellsboro | $4,001.60 | $399.20 – $4,248.90 |
| UPMC Williamsport | Williamsport | $3,831.00 | $439.12 – $3,854.40 |