healthcosts.net
Established Patient Office Visit (level 2) at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$111.60
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.
?
What you pay up front if you don't use insurance.
$186.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$28.60 with UPMC Health Plan vs $234.70 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $28.60 | ↓ -74% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $31.20 | ↓ -72% |
| Aetna | CHIP/Medicaid | $33.80 | ↓ -70% |
| Aetna of PA | Medicare | $36.08 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicaid | $38.56 | ↓ -65% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $39.21 | ↓ -65% |
| Geisinger | Medicaid/CHIP | $40.47 | ↓ -64% |
| Highmark BCBS of PA | Medicare Advantage | $40.64 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $41.14 | ↓ -63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $44.31 | ↓ -60% |
| Aetna | Medicare | $46.50 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $62.64 | ↓ -44% |
| Multiplan | Worker's Compensation | $72.84 | ↓ -35% |
| Highmark BCBS of PA | Managed Care - Social Mission | $87.62 | ↓ -21% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $90.11 | ↓ -19% |
| Highmark Wholecare (prev Gateway) | Medicare | $93.00 | ↓ -17% |
| Highmark BCBS of PA | Managed Care | $117.35 | ↑ +5% |
| Highmark BCBS of PA | Commercial - Indemnity | $120.69 | ↑ +8% |
| Preferred Healthcare System | PPO | $120.90 | ↑ +8% |
| Coventry/First Health | Commercial | $130.20 | ↑ +17% |
| Fidelis | Medicare | $139.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $139.50 | ↑ +25% |
| Health Coalition Partners | Intergroup | $148.80 | ↑ +33% |
| Multiplan | PPO | $148.80 | ↑ +33% |
| Private Health Care Systems | PPO | $148.80 | ↑ +33% |
| SelectCare | Commercial | $148.80 | ↑ +33% |
| Health Payors Organization | Commercial | $158.10 | ↑ +42% |
| Humana | Commercial | $158.10 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $158.10 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $234.70 | ↑ +110% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 2) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $125.40 | $28.60 – $177.65 |
| UPMC Magee | Pittsburgh | $137.40 | $28.60 – $210.68 |
| UPMC Mercy | Pittsburgh | $117.00 | $28.60 – $175.50 |
| UPMC St. Margaret | Pittsburgh | $163.80 | $28.60 – $232.05 |
| UPMC Western Psychiatric | Pittsburgh | $283.20 | $39.83 – $148.75 |
| UPMC East | Monroeville | $138.60 | $28.60 – $184.80 |
| UPMC Altoona | Altoona | $207.00 | $20.00 – $276.00 |
| UPMC Bedford | Everett | $104.40 | $27.30 – $156.60 |