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Inj proc elbow arthro at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$777.00
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.
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What you pay up front if you don't use insurance.
$1,295.00
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.
$42.00 with United Healthcare Community Plan for Families vs $1,100.75 with InterGroup — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $42.00 | ↓ -95% |
| Highmark BCBS of PA | Medicare Advantage | $131.35 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $146.79 | ↓ -81% |
| Multiplan | Worker's Compensation | $170.69 | ↓ -78% |
| UPMC Health Plan | Commercial | $228.23 | ↓ -71% |
| Aetna | CHIP/Medicaid | $233.10 | ↓ -70% |
| Aetna | Medicare | $323.75 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $325.61 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $436.04 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicare | $647.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $668.72 | ↓ -14% |
| Geisinger | Medicaid/CHIP | $712.25 | ↓ -8% |
| Preferred Healthcare System | PPO | $841.75 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $872.07 | ↑ +12% |
| Highmark BCBS of PA | Commercial - Indemnity | $895.57 | ↑ +15% |
| Coventry/First Health | Commercial | $906.50 | ↑ +17% |
| Fidelis | Medicare | $971.25 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $971.25 | ↑ +25% |
| Health Coalition Partners | Intergroup | $1,036.00 | ↑ +33% |
| Multiplan | PPO | $1,036.00 | ↑ +33% |
| Private Health Care Systems | PPO | $1,036.00 | ↑ +33% |
| SelectCare | Commercial | $1,036.00 | ↑ +33% |
| Health Payors Organization | Commercial | $1,100.75 | ↑ +42% |
| Humana | Commercial | $1,100.75 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $1,100.75 | ↑ +42% |
Visitor-reported prices
Comments
Inj proc elbow arthro at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $666.60 | $131.35 – $944.35 |
| UPMC Mercy | Pittsburgh | $1,070.40 | $130.12 – $1,605.60 |
| UPMC St. Margaret | Pittsburgh | $381.60 | $131.35 – $540.60 |
| UPMC Muncy | Muncy | $969.00 | $44.80 – $1,292.00 |
| UPMC Northwest | Seneca | $450.00 | $160.65 – $637.50 |
| UPMC Somerset | Somerset | $461.40 | $40.25 – $576.75 |
| UPMC Wellsboro | Wellsboro | $1,172.00 | $44.80 – $1,318.50 |
| UPMC Williamsport | Williamsport | $969.00 | $44.80 – $1,292.00 |