healthcosts.net
Inj sulf hexa lipid microsph at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$529.20
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.
$882.00
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.
$11.74 with UPMC Health Plan vs $195.66 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $11.74 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $18.59 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $18.59 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $18.59 | ↓ -96% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $18.59 | ↓ -96% |
| UPMC Health Plan | Commercial | $22.87 | ↓ -96% |
| Highmark BCBS of PA | Medicare Advantage | $23.32 | ↓ -96% |
| Aetna | CHIP/Medicaid | $31.68 | ↓ -94% |
| Aetna | Medicare | $44.00 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $57.52 | ↓ -89% |
| Multiplan | Worker's Compensation | $66.88 | ↓ -87% |
| Highmark BCBS of PA | Managed Care - Social Mission | $73.05 | ↓ -86% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $75.12 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicare | $88.00 | ↓ -83% |
| Highmark BCBS of PA | Managed Care | $97.83 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Indemnity | $100.61 | ↓ -81% |
| Preferred Healthcare System | PPO | $114.40 | ↓ -78% |
| Coventry/First Health | Commercial | $123.20 | ↓ -77% |
| Fidelis | Medicare | $132.00 | ↓ -75% |
| InterGroup | InterGroup Services Corporation | $132.00 | ↓ -75% |
| Health Coalition Partners | Intergroup | $140.80 | ↓ -73% |
| Multiplan | PPO | $140.80 | ↓ -73% |
| Private Health Care Systems | PPO | $140.80 | ↓ -73% |
| SelectCare | Commercial | $140.80 | ↓ -73% |
| Health Payors Organization | Commercial | $149.60 | ↓ -72% |
| Humana | Commercial | $149.60 | ↓ -72% |
| InterGroup | Approved National Affiliated PPO Business | $149.60 | ↓ -72% |
| Highmark BCBS of PA | UPMC Emergent | $195.66 | ↓ -63% |
Visitor-reported prices
Comments
Inj sulf hexa lipid microsph at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $397.80 | $11.74 – $596.70 |
| UPMC Passavant-McCandless | Pittsburgh | $398.40 | $11.74 – $149.60 |
| UPMC St. Margaret | Pittsburgh | $373.20 | $11.74 – $528.70 |
| UPMC Western Psychiatric | Pittsburgh | $105.60 | $18.59 – $149.60 |