healthcosts.net
Factor ix recombinant nos at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$34.65
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.
$57.75
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.
$1.17 with UPMC Health Plan vs $48.45 with Humana — 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 | Managed Medicaid | $1.17 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $1.85 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1.85 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1.85 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1.85 | ↓ -95% |
| Aetna | CHIP/Medicaid | $1.96 | ↓ -94% |
| AmeriHealth Caritas | Medicare | $2.00 | ↓ -94% |
| United Healthcare | Medicare | $2.00 | ↓ -94% |
| Cigna Lifesource | Medicare Transplant | $2.00 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $2.00 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2.00 | ↓ -94% |
| Aetna | Medicare | $2.04 | ↓ -94% |
| Aetna of PA | Medicare | $2.04 | ↓ -94% |
| Highmark BCBS of PA | Medicare Advantage | $2.10 | ↓ -94% |
| UPMC Health Plan | Commercial | $2.27 | ↓ -93% |
| Highmark BCBS of PA | Managed Care - Social Mission | $6.58 | ↓ -81% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6.77 | ↓ -80% |
| Highmark BCBS of PA | Managed Care | $8.81 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity | $9.07 | ↓ -74% |
| Highmark BCBS of PA | UPMC Emergent | $17.63 | ↓ -49% |
| UPMC Work Partners | Workers Comp | $18.63 | ↓ -46% |
| Multiplan | Worker's Compensation | $21.66 | ↓ -37% |
| Preferred Healthcare System | PPO | $37.05 | ↑ +7% |
| Coventry/First Health | Commercial | $39.90 | ↑ +15% |
| Fidelis | Medicare | $42.75 | ↑ +23% |
| InterGroup | InterGroup Services Corporation | $42.75 | ↑ +23% |
| Health Coalition Partners | Intergroup | $45.60 | ↑ +32% |
| Private Health Care Systems | PPO | $45.60 | ↑ +32% |
| SelectCare | Commercial | $45.60 | ↑ +32% |
| Multiplan | PPO | $45.60 | ↑ +32% |
| InterGroup | Approved National Affiliated PPO Business | $48.45 | ↑ +40% |
| Health Payors Organization | Commercial | $48.45 | ↑ +40% |
| Humana | Commercial | $48.45 | ↑ +40% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Factor ix recombinant nos at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $15.40 | $0.71 – $2.28 |
| UPMC Passavant-McCandless | Pittsburgh | $34.65 | $1.17 – $49.09 |
| UPMC Western Psychiatric | Pittsburgh | $34.65 | $1.85 – $49.09 |
| UPMC St. Margaret | Pittsburgh | not published | $0.64 – $2.15 |
| UPMC Somerset | Somerset | $2,040.00 | $1.83 – $637.50 |
| UPMC Northwest | Seneca | not published | $0.91 – $2.15 |