healthcosts.net
Mayo analysis gene smn1 dosage/deletion at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2,547.60
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.
?
What you pay up front if you don't use insurance.
$4,246.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$84.46 with Highmark BCBS of PA vs $553.28 with UPMC Health Plan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 BCBS of PA | Medicare Advantage | $84.46 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $109.60 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $120.56 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $131.52 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $135.40 | ↓ -95% |
| Highmark BCBS of PA | Managed Care - Social Mission | $140.39 | ↓ -94% |
| Aetna | CHIP/Medicaid | $142.48 | ↓ -94% |
| AmeriHealth Caritas | Medicare | $147.96 | ↓ -94% |
| United Healthcare | Medicare | $147.96 | ↓ -94% |
| Cigna Lifesource | Medicare Transplant | $147.96 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $147.96 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $147.96 | ↓ -94% |
| Aetna | Medicare | $150.70 | ↓ -94% |
| Aetna of PA | Medicare | $150.70 | ↓ -94% |
| Multiplan | Worker's Compensation | $157.44 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $162.54 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $170.61 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $173.43 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $186.78 | ↓ -93% |
| Highmark BCBS of PA | Managed Care | $188.00 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $221.90 | ↓ -91% |
| Highmark BCBS of PA | Commercial - Indemnity | $297.17 | ↓ -88% |
| Highmark BCBS of PA | UPMC Emergent | $376.00 | ↓ -85% |
| Preferred Healthcare System | PPO | $401.70 | ↓ -84% |
| Coventry/First Health | Commercial | $432.60 | ↓ -83% |
| Fidelis | Medicare | $463.50 | ↓ -82% |
| InterGroup | InterGroup Services Corporation | $463.50 | ↓ -82% |
| Health Coalition Partners | Intergroup | $494.40 | ↓ -81% |
| Private Health Care Systems | PPO | $494.40 | ↓ -81% |
| SelectCare | Commercial | $494.40 | ↓ -81% |
| Multiplan | PPO | $494.40 | ↓ -81% |
| InterGroup | Approved National Affiliated PPO Business | $525.30 | ↓ -79% |
| Health Payors Organization | Commercial | $525.30 | ↓ -79% |
| Humana | Commercial | $525.30 | ↓ -79% |
| UPMC Health Plan | Commercial | $553.28 | ↓ -78% |
Visitor-reported prices
Comments
Mayo analysis gene smn1 dosage/deletion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,261.80 | $84.46 – $487.90 |
| UPMC Mercy | Pittsburgh | $730.20 | $83.66 – $556.20 |
| UPMC St. Margaret | Pittsburgh | $2,547.60 | $84.46 – $1,034.45 |
| UPMC Muncy | Muncy | $1,135.80 | $120.56 – $918.40 |
| UPMC Northwest | Seneca | $2,547.60 | $120.56 – $525.30 |
| UPMC Somerset | Somerset | $792.60 | $82.82 – $990.75 |
| UPMC Wellsboro | Wellsboro | $2,514.40 | $109.60 – $1,033.20 |
| UPMC Williamsport | Williamsport | $1,192.80 | $120.56 – $964.00 |