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Lower Back (Lumbar Spine) MRI (without contrast) at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$6,214.20
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.
$10,357.00
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.
$224.64 with United Healthcare Community Plan for Families vs $8,803.45 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 | $224.64 | ↓ -96% |
| AmeriHealth Caritas | Medicare | $248.89 | ↓ -96% |
| United Healthcare | Medicare | $248.89 | ↓ -96% |
| Cigna Lifesource | Medicare Transplant | $248.89 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicare | $248.89 | ↓ -96% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $248.89 | ↓ -96% |
| Aetna | Medicare | $253.50 | ↓ -96% |
| Aetna of PA | Medicare | $253.50 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $281.76 | ↓ -95% |
| Aetna | CHIP/Medicaid | $333.00 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $379.87 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $386.27 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $398.75 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $405.33 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $436.53 | ↓ -93% |
| Highmark BCBS of PA | Medicare Advantage | $625.38 | ↓ -90% |
| Premier Comp Solutions | Worker's Comp | $1,273.48 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $1,368.99 | ↓ -78% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,550.24 | ↓ -75% |
| Multiplan | Worker's Compensation | $1,591.85 | ↓ -74% |
| Highmark BCBS of PA | Managed Care | $2,075.97 | ↓ -67% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,923.98 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,915.92 | ↓ -37% |
| Highmark BCBS of PA | UPMC Emergent | $4,151.94 | ↓ -33% |
| UPMC Health Plan | Commercial | $4,856.40 | ↓ -22% |
| Preferred Healthcare System | PPO | $6,732.05 | ↑ +8% |
| Coventry/First Health | Commercial | $7,249.90 | ↑ +17% |
| Fidelis | Medicare | $7,767.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $7,767.75 | ↑ +25% |
| Health Coalition Partners | Intergroup | $8,285.60 | ↑ +33% |
| Private Health Care Systems | PPO | $8,285.60 | ↑ +33% |
| SelectCare | Commercial | $8,285.60 | ↑ +33% |
| Multiplan | PPO | $8,285.60 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $8,803.45 | ↑ +42% |
| Health Payors Organization | Commercial | $8,803.45 | ↑ +42% |
| Humana | Commercial | $8,803.45 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,801.60 | $214.16 – $5,385.60 |
| UPMC Magee | Pittsburgh | $4,272.00 | $215.68 – $6,550.40 |
| UPMC Mercy | Pittsburgh | $4,125.00 | $192.10 – $6,187.50 |
| UPMC St. Margaret | Pittsburgh | $3,682.80 | $198.97 – $5,217.30 |
| UPMC East | Monroeville | $3,940.80 | $231.07 – $5,254.40 |
| UPMC Hamot | Erie | $1,623.00 | $183.52 – $1,893.50 |
| UPMC Horizon-Greenville | Greenville | $4,861.20 | $206.32 – $6,886.70 |
| UPMC Jameson | New Castle | $1,519.80 | $197.92 – $2,229.04 |