healthcosts.net
Debride/subq tissue/ea add 20sq cm 11045 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
not published by hospital
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.
not published by hospital
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.
$17.34 with United Healthcare Community Plan for Families vs $389.32 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $17.34 | — |
| UPMC Work Partners | Workers Comp | $51.93 | — |
| Highmark BCBS of PA | Medicare Advantage | $57.10 | — |
| Multiplan | Worker's Compensation | $60.38 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $141.55 | — |
| UPMC Health Plan | Commercial | $189.40 | — |
| Highmark BCBS of PA | Managed Care | $189.55 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $290.70 | — |
| Highmark BCBS of PA | UPMC Emergent | $379.10 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $389.32 | — |
Visitor-reported prices
Comments
Debride/subq tissue/ea add 20sq cm 11045 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $912.60 | $46.42 – $1,292.85 |
| UPMC Mercy | Pittsburgh | $817.20 | $51.93 – $1,225.80 |
| UPMC St. Margaret | Pittsburgh | $811.20 | $46.42 – $1,149.20 |
| UPMC Muncy | Muncy | $728.40 | $18.50 – $971.20 |
| UPMC Northwest | Seneca | $1,588.80 | $46.42 – $2,250.80 |
| UPMC Wellsboro | Wellsboro | $728.40 | $3.96 – $46.42 |
| UPMC Williamsport | Williamsport | $728.40 | $18.50 – $971.20 |