healthcosts.net
Injection, inclisiran, 1 mg at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$53.85
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.
$89.75
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.
$5.25 with Highmark BCBS of PA vs $75.65 with Humana — 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 BCBS of PA | Medicare Advantage | $5.25 | ↓ -90% |
| UPMC Health Plan | Managed Medicaid | $7.78 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $12.32 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $12.32 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.32 | ↓ -77% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $12.32 | ↓ -77% |
| Aetna | CHIP/Medicaid | $13.06 | ↓ -76% |
| AmeriHealth Caritas | Medicare | $13.31 | ↓ -75% |
| United Healthcare | Medicare | $13.31 | ↓ -75% |
| Cigna Lifesource | Medicare Transplant | $13.31 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicare | $13.31 | ↓ -75% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $13.31 | ↓ -75% |
| Aetna | Medicare | $13.55 | ↓ -75% |
| Aetna of PA | Medicare | $13.55 | ↓ -75% |
| UPMC Health Plan | Commercial | $15.15 | ↓ -72% |
| Highmark BCBS of PA | Managed Care - Social Mission | $16.45 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $16.92 | ↓ -69% |
| Highmark BCBS of PA | Managed Care | $22.04 | ↓ -59% |
| Highmark BCBS of PA | Commercial - Indemnity | $22.66 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $29.09 | ↓ -46% |
| Multiplan | Worker's Compensation | $33.82 | ↓ -37% |
| Highmark BCBS of PA | UPMC Emergent | $44.07 | ↓ -18% |
| Preferred Healthcare System | PPO | $57.85 | ↑ +7% |
| Coventry/First Health | Commercial | $62.30 | ↑ +16% |
| Fidelis | Medicare | $66.75 | ↑ +24% |
| InterGroup | InterGroup Services Corporation | $66.75 | ↑ +24% |
| Health Coalition Partners | Intergroup | $71.20 | ↑ +32% |
| Private Health Care Systems | PPO | $71.20 | ↑ +32% |
| SelectCare | Commercial | $71.20 | ↑ +32% |
| Multiplan | PPO | $71.20 | ↑ +32% |
| InterGroup | Approved National Affiliated PPO Business | $75.65 | ↑ +40% |
| Health Payors Organization | Commercial | $75.65 | ↑ +40% |
| Humana | Commercial | $75.65 | ↑ +40% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Injection, inclisiran, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $22.80 | $5.20 – $34.20 |
| UPMC Passavant-McCandless | Pittsburgh | $53.85 | $5.25 – $76.29 |
| UPMC Western Psychiatric | Pittsburgh | $53.85 | $5.15 – $76.29 |
| UPMC Muncy | Muncy | $39.20 | $7.35 – $44.10 |
| UPMC Northwest | Seneca | $22.80 | $7.78 – $32.30 |
| UPMC Somerset | Somerset | $1,348.80 | $5.15 – $1,686.00 |
| UPMC Wellsboro | Wellsboro | $39.20 | $8.82 – $44.10 |
| UPMC Williamsport | Williamsport | $39.20 | $10.31 – $34.20 |