healthcosts.net
Kidney (Retroperitoneal) Ultrasound (complete) at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,263.00
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.
$2,105.00
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.
$58.80 with United Healthcare Community Plan for Families vs $1,789.25 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $58.80 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $89.65 | ↓ -93% |
| Aetna | CHIP/Medicaid | $105.95 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -91% |
| United Healthcare | Medicare | $109.49 | ↓ -91% |
| Cigna Lifesource | Medicare Transplant | $109.49 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.49 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -91% |
| Aetna | Medicare | $111.52 | ↓ -91% |
| Aetna of PA | Medicare | $111.52 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $120.86 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $122.90 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $126.87 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $128.97 | ↓ -90% |
| Highmark BCBS of PA | Medicare Advantage | $131.67 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $138.89 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $287.88 | ↓ -77% |
| Highmark BCBS of PA | Managed Care - Social Mission | $326.40 | ↓ -74% |
| Multiplan | Worker's Compensation | $334.74 | ↓ -73% |
| Highmark BCBS of PA | Managed Care | $437.10 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $615.64 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Indemnity | $824.50 | ↓ -35% |
| Highmark BCBS of PA | UPMC Emergent | $874.19 | ↓ -31% |
| UPMC Health Plan | Commercial | $987.03 | ↓ -22% |
| Preferred Healthcare System | PPO | $1,368.25 | ↑ +8% |
| Coventry/First Health | Commercial | $1,473.50 | ↑ +17% |
| Fidelis | Medicare | $1,578.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $1,578.75 | ↑ +25% |
| Health Coalition Partners | Intergroup | $1,684.00 | ↑ +33% |
| Private Health Care Systems | PPO | $1,684.00 | ↑ +33% |
| SelectCare | Commercial | $1,684.00 | ↑ +33% |
| Multiplan | PPO | $1,684.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $1,789.25 | ↑ +42% |
| Health Payors Organization | Commercial | $1,789.25 | ↑ +42% |
| Humana | Commercial | $1,789.25 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Kidney (Retroperitoneal) Ultrasound (complete) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,469.40 | $89.65 – $2,081.65 |
| UPMC Magee | Pittsburgh | $469.80 | $89.65 – $720.36 |
| UPMC Mercy | Pittsburgh | $706.20 | $84.51 – $1,059.30 |
| UPMC St. Margaret | Pittsburgh | $861.00 | $87.53 – $1,219.75 |
| UPMC East | Monroeville | $1,200.60 | $89.65 – $1,600.80 |
| UPMC Hamot | Erie | $442.20 | $85.14 – $515.90 |
| UPMC Carlisle | Carlisle | $394.20 | $64.19 – $558.45 |
| UPMC Altoona | Altoona | $726.60 | $49.00 – $968.80 |