healthcosts.net
Exome sequence analysis at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$5,002.20
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.
$8,337.00
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.
$2,999.55 with UPMC Health Plan vs $13,623.71 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $2,999.55 | ↓ -40% |
| Highmark BCBS of PA | Medicare Advantage | $3,060.27 | ↓ -39% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $3,824.00 | ↓ -24% |
| Preferred Healthcare System | PPO | $4,158.05 | ↓ -17% |
| UPMC Health Plan | Managed Medicaid | $4,206.40 | ↓ -16% |
| Coventry/First Health | Commercial | $4,477.90 | ↓ -10% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $4,588.80 | ↓ -8% |
| UPMC Work Partners | Workers Comp | $4,724.17 | ↓ -6% |
| Fidelis | Medicare | $4,797.75 | ↓ -4% |
| InterGroup | InterGroup Services Corporation | $4,797.75 | ↓ -4% |
| Aetna | CHIP/Medicaid | $4,971.20 | ↓ -1% |
| Highmark BCBS of PA | Managed Care - Social Mission | $5,086.75 | ↑ +2% |
| Health Coalition Partners | Intergroup | $5,117.60 | ↑ +2% |
| Private Health Care Systems | PPO | $5,117.60 | ↑ +2% |
| SelectCare | Commercial | $5,117.60 | ↑ +2% |
| Multiplan | PPO | $5,117.60 | ↑ +2% |
| AmeriHealth Caritas | Medicare | $5,162.40 | ↑ +3% |
| United Healthcare | Medicare | $5,162.40 | ↑ +3% |
| Cigna Lifesource | Medicare Transplant | $5,162.40 | ↑ +3% |
| Highmark Wholecare (prev Gateway) | Medicare | $5,162.40 | ↑ +3% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5,162.40 | ↑ +3% |
| Aetna | Medicare | $5,258.00 | ↑ +5% |
| Aetna of PA | Medicare | $5,258.00 | ↑ +5% |
| InterGroup | Approved National Affiliated PPO Business | $5,437.45 | ↑ +9% |
| Health Payors Organization | Commercial | $5,437.45 | ↑ +9% |
| Humana | Commercial | $5,437.45 | ↑ +9% |
| Multiplan | Worker's Compensation | $5,493.22 | ↑ +10% |
| Highmark Wholecare (prev Gateway) | Medicaid | $5,670.99 | ↑ +13% |
| Geisinger | Medicaid/CHIP | $5,952.82 | ↑ +19% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $6,051.10 | ↑ +21% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $6,516.86 | ↑ +30% |
| Highmark BCBS of PA | Managed Care | $6,811.86 | ↑ +36% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $8,040.04 | ↑ +61% |
| Highmark BCBS of PA | Commercial - Indemnity | $10,767.46 | ↑ +115% |
| Highmark BCBS of PA | UPMC Emergent | $13,623.71 | ↑ +172% |