healthcosts.net
Fem/popl revasc w/stent at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$41,308.20
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.
$68,847.00
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.
$468.11 with UPMC Health Plan vs $110,629.91 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 | Managed Medicaid | $468.11 | ↓ -99% |
| Aetna | CHIP/Medicaid | $553.22 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $631.09 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $641.73 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $662.45 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $673.39 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $725.22 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $931.20 | ↓ -98% |
| AmeriHealth Caritas | Medicare | $11,676.82 | ↓ -72% |
| United Healthcare | Medicare | $11,676.82 | ↓ -72% |
| Cigna Lifesource | Medicare Transplant | $11,676.82 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,676.82 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,676.82 | ↓ -72% |
| UPMC Health Plan | Commercial | $11,701.25 | ↓ -72% |
| Aetna | Medicare | $11,893.06 | ↓ -71% |
| Aetna of PA | Medicare | $11,893.06 | ↓ -71% |
| UPMC Work Partners | Workers Comp | $14,892.09 | ↓ -64% |
| Highmark BCBS of PA | Medicare Advantage | $16,226.38 | ↓ -61% |
| Multiplan | Worker's Compensation | $17,316.38 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $40,223.08 | ↓ -3% |
| Preferred Healthcare System | PPO | $44,750.55 | ↑ +8% |
| Coventry/First Health | Commercial | $48,192.90 | ↑ +17% |
| Fidelis | Medicare | $51,635.25 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $51,635.25 | ↑ +25% |
| Highmark BCBS of PA | Managed Care | $53,863.96 | ↑ +30% |
| Health Coalition Partners | Intergroup | $55,077.60 | ↑ +33% |
| Private Health Care Systems | PPO | $55,077.60 | ↑ +33% |
| SelectCare | Commercial | $55,077.60 | ↑ +33% |
| Multiplan | PPO | $55,077.60 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $58,519.95 | ↑ +42% |
| Health Payors Organization | Commercial | $58,519.95 | ↑ +42% |
| Humana | Commercial | $58,519.95 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $82,607.95 | ↑ +100% |
| Highmark BCBS of PA | UPMC Emergent | $107,727.92 | ↑ +161% |
| Highmark BCBS of PA | Commercial - Indemnity | $110,629.91 | ↑ +168% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Fem/popl revasc w/stent at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $38,983.80 | $10,047.47 – $55,227.05 |
| UPMC Mercy | Pittsburgh | $34,849.20 | $468.11 – $52,273.80 |
| UPMC St. Margaret | Pittsburgh | $35,730.60 | $9,334.97 – $50,618.35 |
| UPMC Northwest | Seneca | $34,620.00 | $9,805.28 – $49,045.00 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $7,915.20 | $993.28 – $13,195.02 |