Hydrocolld drg <=16 without bdr at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$13.20
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.
$22.00
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 $59.12 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 | ↓ -99% |
| Aetna | Medicare | $0.25 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicare | $0.50 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $0.55 | ↓ -96% |
| Preferred Healthcare System | PPO | $0.65 | ↓ -95% |
| Coventry/First Health | Commercial | $0.70 | ↓ -95% |
| Fidelis | Medicare | $0.75 | ↓ -94% |
| InterGroup | InterGroup Services Corporation | $0.75 | ↓ -94% |
| Multiplan | PPO | $0.80 | ↓ -94% |
| SelectCare | Commercial | $0.80 | ↓ -94% |
| Health Coalition Partners | Intergroup | $0.80 | ↓ -94% |
| Private Health Care Systems | PPO | $0.80 | ↓ -94% |
| InterGroup | Approved National Affiliated PPO Business | $0.85 | ↓ -94% |
| Humana | Commercial | $0.85 | ↓ -94% |
| Health Payors Organization | Commercial | $0.85 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $7.07 | ↓ -46% |
| Highmark BCBS of PA | Medicare Advantage | $11.71 | ↓ -11% |
| UPMC Work Partners | Workers Comp | $15.06 | ↑ +14% |
| Multiplan | Worker's Compensation | $17.51 | ↑ +33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $19.46 | ↑ +47% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $19.82 | ↑ +50% |
| Highmark BCBS of PA | Managed Care | $26.06 | ↑ +97% |
| Highmark BCBS of PA | Commercial - Indemnity | $26.54 | ↑ +101% |
| Highmark BCBS of PA | UPMC Emergent | $52.13 | ↑ +295% |
| UPMC Health Plan | Commercial | $59.12 | ↑ +348% |
Visitor-reported prices
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Hydrocolld drg <=16 without bdr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $26.40 | $6.17 – $36.57 |
| UPMC Mercy | Pittsburgh | $3.00 | $11.60 – $28.88 |
| UPMC Passavant-McCandless | Pittsburgh | $15.60 | $11.71 – $53.06 |
| UPMC St. Margaret | Pittsburgh | $3.60 | $11.71 – $44.87 |
| UPMC Altoona | Altoona | $3.60 | $0.50 – $36.57 |
| UPMC Bedford | Everett | $1.80 | $0.25 – $36.57 |
| UPMC East | Monroeville | $3.60 | $0.25 – $36.57 |
| UPMC Hamot | Erie | $3.60 | $11.60 – $15.06 |