healthcosts.net
Mammosite ced at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2,988.00
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.
$4,980.00
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.
$597.60 with Highmark Wholecare (prev Gateway) vs $5,762.95 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $597.60 | ↓ -80% |
| Aetna | CHIP/Medicaid | $896.40 | ↓ -70% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $946.20 | ↓ -68% |
| Aetna | Medicare | $1,245.00 | ↓ -58% |
| Highmark BCBS of PA | Medicare Advantage | $1,294.52 | ↓ -57% |
| Geisinger | Medicaid/CHIP | $1,643.40 | ↓ -45% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,684.73 | ↓ -44% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,151.74 | ↓ -28% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,190.79 | ↓ -27% |
| Aetna | First Health | $2,490.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,490.00 | ↓ -17% |
| Highmark BCBS of PA | Managed Care | $2,881.48 | ↓ -4% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,933.70 | ↓ -2% |
| Preferred Healthcare System | PPO | $3,237.00 | ↑ +8% |
| Coventry/First Health | Commercial | $3,486.00 | ↑ +17% |
| Fidelis | Medicare | $3,735.00 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $3,735.00 | ↑ +25% |
| Health Coalition Partners | Intergroup | $3,984.00 | ↑ +33% |
| Multiplan | PPO | $3,984.00 | ↑ +33% |
| Private Health Care Systems | PPO | $3,984.00 | ↑ +33% |
| SelectCare | Commercial | $3,984.00 | ↑ +33% |
| Health Payors Organization | Commercial | $4,233.00 | ↑ +42% |
| Humana | Commercial | $4,233.00 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $4,233.00 | ↑ +42% |
| UPMC Health Plan | Commercial | $4,318.04 | ↑ +45% |
| Highmark BCBS of PA | UPMC Emergent | $5,762.95 | ↑ +93% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Mammosite ced at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Muncy | Muncy | $11,007.00 | $2,751.75 – $16,510.50 |
| UPMC Somerset | Somerset | $120.00 | $78.76 – $1,599.65 |
| UPMC Wellsboro | Wellsboro | $13,311.20 | $2,995.02 – $14,975.10 |