Gauze <=16 in no w/sal without b at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2.40
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.
$4.00
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.
$0.18 with Aetna vs $19.29 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $0.18 | ↓ -93% |
| Aetna | Medicare | $0.25 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $0.50 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $0.55 | ↓ -77% |
| Preferred Healthcare System | PPO | $0.65 | ↓ -73% |
| Coventry/First Health | Commercial | $0.70 | ↓ -71% |
| Fidelis | Medicare | $0.75 | ↓ -69% |
| InterGroup | InterGroup Services Corporation | $0.75 | ↓ -69% |
| Multiplan | PPO | $0.80 | ↓ -67% |
| SelectCare | Commercial | $0.80 | ↓ -67% |
| Health Coalition Partners | Intergroup | $0.80 | ↓ -67% |
| Private Health Care Systems | PPO | $0.80 | ↓ -67% |
| InterGroup | Approved National Affiliated PPO Business | $0.85 | ↓ -65% |
| Humana | Commercial | $0.85 | ↓ -65% |
| Health Payors Organization | Commercial | $0.85 | ↓ -65% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $2.29 | ↓ -5% |
| Highmark BCBS of PA | Medicare Advantage | $3.81 | ↑ +59% |
| UPMC Work Partners | Workers Comp | $4.93 | ↑ +105% |
| Multiplan | Worker's Compensation | $5.73 | ↑ +139% |
| Highmark BCBS of PA | Managed Care - Social Mission | $6.33 | ↑ +164% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6.45 | ↑ +169% |
| Highmark BCBS of PA | Managed Care | $8.48 | ↑ +253% |
| Highmark BCBS of PA | Commercial - Indemnity | $8.63 | ↑ +260% |
| Highmark BCBS of PA | UPMC Emergent | $16.96 | ↑ +607% |
| UPMC Health Plan | Commercial | $19.29 | ↑ +704% |
Visitor-reported prices
Comments
Gauze <=16 in no w/sal without b at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $0.60 | $3.77 – $9.42 |
| UPMC McKeesport | Mckeesport | $0.60 | $2.01 – $11.93 |
| UPMC Wellsboro | Wellsboro | $0.60 | $2.44 – $4.93 |