healthcosts.net
Icd reliance df4 ib 64cm at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$68,619.60
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.
$114,366.00
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.
$1,124.04 with Highmark Wholecare (prev Gateway) vs $34,860.21 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $1,124.04 | ↓ -98% |
| Aetna | CHIP/Medicaid | $1,686.06 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1,779.73 | ↓ -97% |
| Aetna | Medicare | $2,341.75 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $3,091.11 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3,168.86 | ↓ -95% |
| Highmark BCBS of PA | Medicare Advantage | $4,666.50 | ↓ -93% |
| Aetna | First Health | $4,683.50 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,683.50 | ↓ -93% |
| Preferred Healthcare System | PPO | $6,088.55 | ↓ -91% |
| Coventry/First Health | Commercial | $6,556.90 | ↓ -90% |
| Fidelis | Medicare | $7,025.25 | ↓ -90% |
| InterGroup | InterGroup Services Corporation | $7,025.25 | ↓ -90% |
| Health Coalition Partners | Intergroup | $7,493.60 | ↓ -89% |
| Multiplan | PPO | $7,493.60 | ↓ -89% |
| Private Health Care Systems | PPO | $7,493.60 | ↓ -89% |
| SelectCare | Commercial | $7,493.60 | ↓ -89% |
| Highmark BCBS of PA | Managed Care - Social Mission | $7,756.61 | ↓ -89% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7,897.36 | ↓ -88% |
| Health Payors Organization | Commercial | $7,961.95 | ↓ -88% |
| Humana | Commercial | $7,961.95 | ↓ -88% |
| InterGroup | Approved National Affiliated PPO Business | $7,961.95 | ↓ -88% |
| Highmark BCBS of PA | Managed Care | $10,387.16 | ↓ -85% |
| Highmark BCBS of PA | Commercial - Indemnity | $10,575.41 | ↓ -85% |
| Highmark BCBS of PA | UPMC Emergent | $20,774.31 | ↓ -70% |
| UPMC Health Plan | Commercial | $34,860.21 | ↓ -49% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
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Icd reliance df4 ib 64cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $15,159.00 | $4,622.48 – $22,738.50 |
| UPMC Passavant-McCandless | Pittsburgh | $24,073.20 | $4,666.50 – $32,172.50 |
| UPMC Somerset | Somerset | $18,804.00 | $4,575.73 – $23,505.00 |
| UPMC Williamsport | Williamsport | $14,973.00 | $4,991.00 – $22,459.50 |