healthcosts.net
Kyleena, 19.5 mg at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2,036.40
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.
$3,394.00
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.
$610.92 with Aetna vs $5,255.13 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $610.92 | ↓ -70% |
| Highmark BCBS of PA | Medicare Advantage | $626.47 | ↓ -69% |
| Aetna | Medicare | $848.50 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $1,109.16 | ↓ -46% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $1,125.67 | ↓ -45% |
| Multiplan | Worker's Compensation | $1,289.72 | ↓ -37% |
| UPMC Health Plan | Commercial | $1,384.68 | ↓ -32% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,697.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $1,866.70 | ↓ -8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,961.90 | ↓ -4% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,017.69 | ↓ -1% |
| Preferred Healthcare System | PPO | $2,206.10 | ↑ +8% |
| Coventry/First Health | Commercial | $2,375.80 | ↑ +17% |
| Fidelis | Medicare | $2,545.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $2,545.50 | ↑ +25% |
| Highmark BCBS of PA | Managed Care | $2,627.57 | ↑ +29% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,702.28 | ↑ +33% |
| Health Coalition Partners | Intergroup | $2,715.20 | ↑ +33% |
| Multiplan | PPO | $2,715.20 | ↑ +33% |
| Private Health Care Systems | PPO | $2,715.20 | ↑ +33% |
| SelectCare | Commercial | $2,715.20 | ↑ +33% |
| Health Payors Organization | Commercial | $2,884.90 | ↑ +42% |
| Humana | Commercial | $2,884.90 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $2,884.90 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $5,255.13 | ↑ +158% |
Visitor-reported prices
Comments
Kyleena, 19.5 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,036.40 | $626.47 – $2,884.90 |
| UPMC Muncy | Muncy | $2,489.60 | $466.80 – $2,800.80 |
| UPMC Wellsboro | Wellsboro | $2,489.60 | $449.46 – $2,247.30 |
| UPMC Williamsport | Williamsport | $3,100.20 | $840.24 – $2,800.80 |