healthcosts.net
Mitomycin instillation at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$858.00
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.
?
What you pay up front if you don't use insurance.
$1,430.00
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.
$201.12 with UPMC Health Plan vs $1,783.93 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $201.12 | ↓ -77% |
| Highmark BCBS of PA | Medicare Advantage | $212.66 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $318.53 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicaid | $318.53 | ↓ -63% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $318.53 | ↓ -63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $318.53 | ↓ -63% |
| Aetna | CHIP/Medicaid | $337.64 | ↓ -61% |
| AmeriHealth Caritas | Medicare | $344.01 | ↓ -60% |
| United Healthcare | Medicare | $344.01 | ↓ -60% |
| Cigna Lifesource | Medicare Transplant | $344.01 | ↓ -60% |
| Highmark Wholecare (prev Gateway) | Medicare | $344.01 | ↓ -60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $344.01 | ↓ -60% |
| Aetna | Medicare | $350.38 | ↓ -59% |
| Aetna of PA | Medicare | $350.38 | ↓ -59% |
| UPMC Health Plan | Commercial | $391.79 | ↓ -54% |
| UPMC Work Partners | Workers Comp | $467.32 | ↓ -46% |
| Multiplan | Worker's Compensation | $543.40 | ↓ -37% |
| Highmark BCBS of PA | Managed Care - Social Mission | $666.00 | ↓ -22% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $684.93 | ↓ -20% |
| Highmark BCBS of PA | Managed Care | $891.96 | ↑ +4% |
| Highmark BCBS of PA | Commercial - Indemnity | $917.33 | ↑ +7% |
| Preferred Healthcare System | PPO | $929.50 | ↑ +8% |
| Coventry/First Health | Commercial | $1,001.00 | ↑ +17% |
| Fidelis | Medicare | $1,072.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $1,072.50 | ↑ +25% |
| Health Coalition Partners | Intergroup | $1,144.00 | ↑ +33% |
| Private Health Care Systems | PPO | $1,144.00 | ↑ +33% |
| SelectCare | Commercial | $1,144.00 | ↑ +33% |
| Multiplan | PPO | $1,144.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $1,215.50 | ↑ +42% |
| Health Payors Organization | Commercial | $1,215.50 | ↑ +42% |
| Humana | Commercial | $1,215.50 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $1,783.93 | ↑ +108% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Mitomycin instillation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $54,580.80 | $201.12 – $721.65 |
| UPMC St. Margaret | Pittsburgh | $858.40 | $201.12 – $912.05 |
| UPMC Western Psychiatric | Pittsburgh | $858.00 | $208.39 – $1,215.50 |
| UPMC Muncy | Muncy | $818.40 | $153.45 – $920.70 |
| UPMC Somerset | Somerset | $14,202.00 | $208.53 – $17,752.50 |
| UPMC Wellsboro | Wellsboro | $818.40 | $184.14 – $920.70 |
| UPMC Williamsport | Williamsport | $818.40 | $277.44 – $920.70 |