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Eye implant band 40 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2,927.40
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.
$4,879.00
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.
$225.96 with Highmark Wholecare (prev Gateway) vs $3,401.66 with UPMC Health Plan — 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 Wholecare (prev Gateway) | Medicaid | $225.96 | ↓ -92% |
| Highmark BCBS of PA | Medicare Advantage | $246.07 | ↓ -92% |
| Aetna | CHIP/Medicaid | $338.94 | ↓ -88% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $357.77 | ↓ -88% |
| Highmark BCBS of PA | Managed Care - Social Mission | $409.01 | ↓ -86% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $416.43 | ↓ -86% |
| Aetna | Medicare | $470.75 | ↓ -84% |
| Highmark BCBS of PA | Managed Care | $547.72 | ↓ -81% |
| Highmark BCBS of PA | Commercial - Indemnity | $557.64 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $621.39 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $637.02 | ↓ -78% |
| Aetna | First Health | $941.50 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $941.50 | ↓ -68% |
| Highmark BCBS of PA | UPMC Emergent | $1,095.43 | ↓ -63% |
| Preferred Healthcare System | PPO | $1,223.95 | ↓ -58% |
| Coventry/First Health | Commercial | $1,318.10 | ↓ -55% |
| Fidelis | Medicare | $1,412.25 | ↓ -52% |
| InterGroup | InterGroup Services Corporation | $1,412.25 | ↓ -52% |
| Health Coalition Partners | Intergroup | $1,506.40 | ↓ -49% |
| Multiplan | PPO | $1,506.40 | ↓ -49% |
| Private Health Care Systems | PPO | $1,506.40 | ↓ -49% |
| SelectCare | Commercial | $1,506.40 | ↓ -49% |
| Health Payors Organization | Commercial | $1,600.55 | ↓ -45% |
| Humana | Commercial | $1,600.55 | ↓ -45% |
| InterGroup | Approved National Affiliated PPO Business | $1,600.55 | ↓ -45% |
| UPMC Health Plan | Commercial | $3,401.66 | ↑ +16% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Eye implant band 40 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $4,016.80 | $243.74 – $4,518.90 |
| UPMC Muncy | Muncy | $2,963.40 | $740.85 – $4,445.10 |
| UPMC Wellsboro | Wellsboro | $3,584.00 | $806.40 – $4,032.00 |