Hc i-131 sodium iodide cap dx per mci at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$892.20
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.
$1,487.00
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.
$267.66 with Aetna vs $2,594.27 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $267.66 | ↓ -70% |
| Highmark BCBS of PA | Medicare Advantage | $309.27 | ↓ -65% |
| Aetna | Medicare | $371.75 | ↓ -58% |
| UPMC Health Plan | Commercial | $709.49 | ↓ -20% |
| Highmark Wholecare (prev Gateway) | Medicare | $743.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $817.85 | ↓ -8% |
| Preferred Healthcare System | PPO | $966.55 | ↑ +8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $968.52 | ↑ +9% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $996.06 | ↑ +12% |
| Coventry/First Health | Commercial | $1,040.90 | ↑ +17% |
| InterGroup | InterGroup Services Corporation | $1,115.25 | ↑ +25% |
| Fidelis | Medicare | $1,115.25 | ↑ +25% |
| Private Health Care Systems | PPO | $1,189.60 | ↑ +33% |
| Health Coalition Partners | Intergroup | $1,189.60 | ↑ +33% |
| Multiplan | PPO | $1,189.60 | ↑ +33% |
| SelectCare | Commercial | $1,189.60 | ↑ +33% |
| Health Payors Organization | Commercial | $1,263.95 | ↑ +42% |
| Humana | Commercial | $1,263.95 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $1,263.95 | ↑ +42% |
| Highmark BCBS of PA | Managed Care | $1,297.14 | ↑ +45% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,334.02 | ↑ +50% |
| Highmark BCBS of PA | UPMC Emergent | $2,594.27 | ↑ +191% |
| Multiplan | Worker's Compensation | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Hc i-131 sodium iodide cap dx per mci at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $733.80 | $309.27 – $636.78 |
| UPMC Altoona | Altoona | $603.00 | $283.35 – $804.00 |
| UPMC Carlisle | Carlisle | $184.20 | $42.06 – $260.95 |
| UPMC Community Osteopathic | Harrisburg | $184.20 | $61.40 – $510.09 |
| UPMC Hamot | Erie | $673.80 | $40.70 – $260.30 |
| UPMC Hanover | Hanover | $184.20 | $114.59 – $438.82 |
| UPMC Jameson | New Castle | $369.60 | $66.42 – $438.82 |
| UPMC Lititz | Lititz | $184.20 | $66.42 – $438.82 |