healthcosts.net
Ghs spont nystagmus at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$378.00
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.
?
What you pay up front if you don't use insurance.
$630.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$9.53 with United Healthcare Community Plan for Families vs $535.50 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $9.53 | ↓ -97% |
| Highmark BCBS of PA | Medicare Advantage | $28.99 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $29.93 | ↓ -92% |
| Aetna | CHIP/Medicaid | $35.37 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $40.35 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $41.03 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $42.36 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $43.06 | ↓ -89% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $46.37 | ↓ -88% |
| Highmark BCBS of PA | Managed Care - Social Mission | $71.87 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $81.46 | ↓ -78% |
| Multiplan | Worker's Compensation | $94.72 | ↓ -75% |
| Highmark BCBS of PA | Managed Care | $96.24 | ↓ -75% |
| AmeriHealth Caritas | Medicare | $132.72 | ↓ -65% |
| United Healthcare | Medicare | $132.72 | ↓ -65% |
| Cigna Lifesource | Medicare Transplant | $132.72 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicare | $132.72 | ↓ -65% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $132.72 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $135.11 | ↓ -64% |
| Aetna | Medicare | $135.18 | ↓ -64% |
| Aetna of PA | Medicare | $135.18 | ↓ -64% |
| UPMC Health Plan | Commercial | $157.91 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity | $180.95 | ↓ -52% |
| Highmark BCBS of PA | UPMC Emergent | $192.48 | ↓ -49% |
| Preferred Healthcare System | PPO | $409.50 | ↑ +8% |
| Coventry/First Health | Commercial | $441.00 | ↑ +17% |
| Fidelis | Medicare | $472.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $472.50 | ↑ +25% |
| Health Coalition Partners | Intergroup | $504.00 | ↑ +33% |
| Private Health Care Systems | PPO | $504.00 | ↑ +33% |
| SelectCare | Commercial | $504.00 | ↑ +33% |
| Multiplan | PPO | $504.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $535.50 | ↑ +42% |
| Health Payors Organization | Commercial | $535.50 | ↑ +42% |
| Humana | Commercial | $535.50 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs spont nystagmus at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $250.80 | $28.72 – $376.20 |