healthcosts.net
Ins cath ren art 1st uni at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$10,031.40
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.
$16,719.00
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.
$247.21 with UPMC Health Plan vs $14,211.15 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $247.21 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $269.69 | ↓ -97% |
| Aetna | CHIP/Medicaid | $292.16 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $333.29 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $338.91 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $349.85 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $355.63 | ↓ -96% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $383.00 | ↓ -96% |
| UPMC Health Plan | Commercial | $1,057.92 | ↓ -89% |
| Highmark BCBS of PA | Medicare Advantage | $1,755.75 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $2,312.09 | ↓ -77% |
| Multiplan | Worker's Compensation | $2,688.48 | ↓ -73% |
| AmeriHealth Caritas | Medicare | $3,240.82 | ↓ -68% |
| United Healthcare | Medicare | $3,240.82 | ↓ -68% |
| Cigna Lifesource | Medicare Transplant | $3,240.82 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,240.82 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,240.82 | ↓ -68% |
| Aetna | Medicare | $3,300.84 | ↓ -67% |
| Aetna of PA | Medicare | $3,300.84 | ↓ -67% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,352.27 | ↓ -57% |
| Highmark BCBS of PA | Managed Care | $5,828.26 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $8,938.45 | ↓ -11% |
| Preferred Healthcare System | PPO | $10,867.35 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $11,656.51 | ↑ +16% |
| Coventry/First Health | Commercial | $11,703.30 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $11,970.52 | ↑ +19% |
| Fidelis | Medicare | $12,539.25 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $12,539.25 | ↑ +25% |
| Health Coalition Partners | Intergroup | $13,375.20 | ↑ +33% |
| Private Health Care Systems | PPO | $13,375.20 | ↑ +33% |
| SelectCare | Commercial | $13,375.20 | ↑ +33% |
| Multiplan | PPO | $13,375.20 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $14,211.15 | ↑ +42% |
| Health Payors Organization | Commercial | $14,211.15 | ↑ +42% |
| Humana | Commercial | $14,211.15 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins cath ren art 1st uni at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $7,507.80 | $247.21 – $10,636.05 |
| UPMC Mercy | Pittsburgh | $2,866.20 | $247.21 – $4,299.30 |
| UPMC St. Margaret | Pittsburgh | $8,832.00 | $247.21 – $12,512.00 |
| UPMC Somerset | Somerset | $6,300.60 | $247.21 – $7,875.75 |
| UPMC Williamsport | Williamsport | $2,781.00 | $247.21 – $3,708.00 |