healthcosts.net
Fna bx w/ct gdn ea addl at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,085.40
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.
$1,809.00
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.
$74.79 with UPMC Health Plan vs $1,537.65 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 | Managed Medicaid | $74.79 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $81.59 | ↓ -92% |
| Aetna | CHIP/Medicaid | $88.39 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $100.83 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $102.53 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $105.84 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $107.59 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $115.87 | ↓ -89% |
| Highmark BCBS of PA | Medicare Advantage | $168.66 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $372.56 | ↓ -66% |
| Highmark BCBS of PA | Managed Care - Social Mission | $418.09 | ↓ -61% |
| Multiplan | Worker's Compensation | $433.21 | ↓ -60% |
| Aetna | Medicare | $452.25 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $559.87 | ↓ -48% |
| UPMC Health Plan | Commercial | $662.26 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $858.64 | ↓ -21% |
| Highmark Wholecare (prev Gateway) | Medicare | $904.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $1,119.74 | ↑ +3% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,149.91 | ↑ +6% |
| Preferred Healthcare System | PPO | $1,175.85 | ↑ +8% |
| Coventry/First Health | Commercial | $1,266.30 | ↑ +17% |
| Fidelis | Medicare | $1,356.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $1,356.75 | ↑ +25% |
| Health Coalition Partners | Intergroup | $1,447.20 | ↑ +33% |
| Multiplan | PPO | $1,447.20 | ↑ +33% |
| Private Health Care Systems | PPO | $1,447.20 | ↑ +33% |
| SelectCare | Commercial | $1,447.20 | ↑ +33% |
| Health Payors Organization | Commercial | $1,537.65 | ↑ +42% |
| Humana | Commercial | $1,537.65 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $1,537.65 | ↑ +42% |
Visitor-reported prices
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Fna bx w/ct gdn ea addl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $575.40 | $74.79 – $815.15 |
| UPMC Mercy | Pittsburgh | $738.00 | $74.79 – $1,107.00 |
| UPMC Muncy | Muncy | $726.00 | $74.79 – $968.00 |
| UPMC Somerset | Somerset | $314.40 | $74.79 – $393.00 |
| UPMC Wellsboro | Wellsboro | $877.60 | $74.79 – $987.30 |
| UPMC Williamsport | Williamsport | $726.00 | $74.79 – $968.00 |