healthcosts.net
Lead acuity x4 spiral l 86cm at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$27,605.40
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.
$46,009.00
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.
$825.12 with Highmark Wholecare (prev Gateway) vs $19,428.86 with UPMC Health Plan — 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 Wholecare (prev Gateway) | Medicaid | $825.12 | ↓ -97% |
| Aetna | CHIP/Medicaid | $1,237.68 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1,306.44 | ↓ -95% |
| Aetna | Medicare | $1,719.00 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $2,269.08 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $2,326.15 | ↓ -92% |
| Highmark BCBS of PA | Medicare Advantage | $2,344.46 | ↓ -92% |
| Aetna | First Health | $3,438.00 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,438.00 | ↓ -88% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,896.94 | ↓ -86% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,967.66 | ↓ -86% |
| Preferred Healthcare System | PPO | $4,469.40 | ↓ -84% |
| Coventry/First Health | Commercial | $4,813.20 | ↓ -83% |
| Fidelis | Medicare | $5,157.00 | ↓ -81% |
| InterGroup | InterGroup Services Corporation | $5,157.00 | ↓ -81% |
| Highmark BCBS of PA | Managed Care | $5,218.54 | ↓ -81% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,313.11 | ↓ -81% |
| Health Coalition Partners | Intergroup | $5,500.80 | ↓ -80% |
| Multiplan | PPO | $5,500.80 | ↓ -80% |
| Private Health Care Systems | PPO | $5,500.80 | ↓ -80% |
| SelectCare | Commercial | $5,500.80 | ↓ -80% |
| Health Payors Organization | Commercial | $5,844.60 | ↓ -79% |
| Humana | Commercial | $5,844.60 | ↓ -79% |
| InterGroup | Approved National Affiliated PPO Business | $5,844.60 | ↓ -79% |
| Highmark BCBS of PA | UPMC Emergent | $10,437.07 | ↓ -62% |
| UPMC Health Plan | Commercial | $19,428.86 | ↓ -30% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Lead acuity x4 spiral l 86cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $7,381.80 | $2,322.35 – $11,072.70 |
| UPMC Passavant-McCandless | Pittsburgh | $13,576.80 | $2,344.46 – $19,233.80 |
| UPMC Somerset | Somerset | $9,999.00 | $2,298.86 – $12,498.75 |
| UPMC Williamsport | Williamsport | $4,649.40 | $1,549.80 – $6,974.10 |