healthcosts.net
Explore penetrating wnd/extremity 20103 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$5,807.40
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.
$9,679.00
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.
$598.24 with UPMC Health Plan vs $8,227.15 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $598.24 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $862.13 | ↓ -85% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $931.20 | ↓ -84% |
| Highmark BCBS of PA | Medicare Advantage | $975.80 | ↓ -83% |
| Multiplan | Worker's Compensation | $1,002.48 | ↓ -83% |
| AmeriHealth Caritas | Medicare | $1,668.28 | ↓ -71% |
| Cigna Lifesource | Medicare Transplant | $1,668.28 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.28 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | ↓ -71% |
| United Healthcare | Medicare | $1,668.28 | ↓ -71% |
| Aetna | Medicare | $1,699.17 | ↓ -71% |
| Aetna of PA | Medicare | $1,699.17 | ↓ -71% |
| Aetna | CHIP/Medicaid | $1,742.22 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,418.88 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $3,239.19 | ↓ -44% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,967.76 | ↓ -14% |
| Geisinger | Medicaid/CHIP | $5,323.45 | ↓ -8% |
| Preferred Healthcare System | PPO | $6,291.35 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $6,478.39 | ↑ +12% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,652.90 | ↑ +15% |
| Coventry/First Health | Commercial | $6,775.30 | ↑ +17% |
| Fidelis | Medicare | $7,259.25 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $7,259.25 | ↑ +25% |
| Health Coalition Partners | Intergroup | $7,743.20 | ↑ +33% |
| Multiplan | PPO | $7,743.20 | ↑ +33% |
| Private Health Care Systems | PPO | $7,743.20 | ↑ +33% |
| SelectCare | Commercial | $7,743.20 | ↑ +33% |
| Health Payors Organization | Commercial | $8,227.15 | ↑ +42% |
| Humana | Commercial | $8,227.15 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $8,227.15 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Explore penetrating wnd/extremity 20103 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,954.20 | $710.76 – $2,768.45 |
| UPMC Mercy | Pittsburgh | $2,421.60 | $862.13 – $3,632.40 |
| UPMC St. Margaret | Pittsburgh | $4,569.00 | $705.73 – $6,472.75 |
| UPMC Muncy | Muncy | $3,349.80 | $824.80 – $4,466.40 |
| UPMC Northwest | Seneca | $2,678.40 | $742.83 – $3,794.40 |
| UPMC Somerset | Somerset | $5,344.20 | $767.96 – $6,680.25 |
| UPMC Wellsboro | Wellsboro | $4,051.20 | $767.96 – $4,557.60 |
| UPMC Williamsport | Williamsport | $3,349.80 | $824.80 – $4,466.40 |