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Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$4,494.60
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.
$7,491.00
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.
$626.83 with Highmark BCBS of PA vs $6,367.35 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare Advantage | $626.83 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $694.59 | ↓ -85% |
| Multiplan | Worker's Compensation | $807.66 | ↓ -82% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $931.20 | ↓ -79% |
| Aetna | CHIP/Medicaid | $1,348.38 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,553.82 | ↓ -65% |
| UPMC Health Plan | Commercial | $1,751.12 | ↓ -61% |
| Aetna | Medicare | $1,872.75 | ↓ -58% |
| AmeriHealth Caritas | Medicare | $2,010.67 | ↓ -55% |
| Cigna Lifesource | Medicare Transplant | $2,010.67 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,010.67 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,010.67 | ↓ -55% |
| United Healthcare | Medicare | $2,010.67 | ↓ -55% |
| Aetna of PA | Medicare | $2,047.90 | ↓ -54% |
| Highmark BCBS of PA | Managed Care | $2,080.77 | ↓ -54% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,191.15 | ↓ -29% |
| Geisinger | Medicaid/CHIP | $4,120.05 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $4,161.54 | ↓ -7% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,273.64 | ↓ -5% |
| Preferred Healthcare System | PPO | $4,869.15 | ↑ +8% |
| Coventry/First Health | Commercial | $5,243.70 | ↑ +17% |
| Fidelis | Medicare | $5,618.25 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $5,618.25 | ↑ +25% |
| Health Coalition Partners | Intergroup | $5,992.80 | ↑ +33% |
| Multiplan | PPO | $5,992.80 | ↑ +33% |
| Private Health Care Systems | PPO | $5,992.80 | ↑ +33% |
| SelectCare | Commercial | $5,992.80 | ↑ +33% |
| Health Payors Organization | Commercial | $6,367.35 | ↑ +42% |
| Humana | Commercial | $6,367.35 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $6,367.35 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,192.80 | $618.25 – $5,939.80 |
| UPMC Mercy | Pittsburgh | $7,348.20 | $197.27 – $11,022.30 |
| UPMC St. Margaret | Pittsburgh | $2,615.40 | $618.25 – $3,705.15 |
| UPMC Northwest | Seneca | $4,350.00 | $618.25 – $6,162.50 |
| UPMC Somerset | Somerset | $2,908.20 | $614.63 – $3,635.25 |
| UPMC Williamsport | Williamsport | $3,434.40 | $618.25 – $4,579.20 |