healthcosts.net
Cystoscopy prostatic imp 1-3 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$8,013.60
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.
$13,356.00
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.
$524.04 with Highmark Wholecare (prev Gateway) vs $8,736.63 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $524.04 | ↓ -93% |
| Aetna | CHIP/Medicaid | $786.06 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $829.73 | ↓ -90% |
| Highmark BCBS of PA | Medicare Advantage | $1,281.42 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $1,441.11 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,477.36 | ↓ -82% |
| UPMC Health Plan | Commercial | $2,047.69 | ↓ -74% |
| Aetna | First Health | $2,183.50 | ↓ -73% |
| Preferred Healthcare System | PPO | $2,838.55 | ↓ -65% |
| Coventry/First Health | Commercial | $3,056.90 | ↓ -62% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,176.48 | ↓ -60% |
| Fidelis | Medicare | $3,275.25 | ↓ -59% |
| InterGroup | InterGroup Services Corporation | $3,275.25 | ↓ -59% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $3,442.00 | ↓ -57% |
| Health Coalition Partners | Intergroup | $3,493.60 | ↓ -56% |
| Private Health Care Systems | PPO | $3,493.60 | ↓ -56% |
| SelectCare | Commercial | $3,493.60 | ↓ -56% |
| Multiplan | PPO | $3,493.60 | ↓ -56% |
| InterGroup | Approved National Affiliated PPO Business | $3,711.95 | ↓ -54% |
| Health Payors Organization | Commercial | $3,711.95 | ↓ -54% |
| Humana | Commercial | $3,711.95 | ↓ -54% |
| Highmark BCBS of PA | Managed Care | $4,253.73 | ↓ -47% |
| AmeriHealth Caritas | Medicare | $5,234.35 | ↓ -35% |
| United Healthcare | Medicare | $5,234.35 | ↓ -35% |
| Cigna Lifesource | Medicare Transplant | $5,234.35 | ↓ -35% |
| Highmark Wholecare (prev Gateway) | Medicare | $5,234.35 | ↓ -35% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5,234.35 | ↓ -35% |
| Aetna | Medicare | $5,331.28 | ↓ -33% |
| Aetna of PA | Medicare | $5,331.28 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6,523.69 | ↓ -19% |
| Highmark BCBS of PA | UPMC Emergent | $8,507.46 | ↑ +6% |
| Highmark BCBS of PA | Commercial - Indemnity | $8,736.63 | ↑ +9% |
| Multiplan | Worker's Compensation | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Cystoscopy prostatic imp 1-3 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | not published | $1,269.34 – $5,331.28 |
| UPMC Muncy | Muncy | $5,953.80 | $685.20 – $4,111.20 |
| UPMC Northwest | Seneca | not published | $3,294.42 – $5,234.35 |