healthcosts.net
Mopath procedure level 8 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,687.80
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.
$2,813.00
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.
$60.48 with Aetna vs $8,528.98 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $60.48 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $184.80 | ↓ -89% |
| Preferred Healthcare System | PPO | $218.40 | ↓ -87% |
| Coventry/First Health | Commercial | $235.20 | ↓ -86% |
| Fidelis | Medicare | $252.00 | ↓ -85% |
| InterGroup | InterGroup Services Corporation | $252.00 | ↓ -85% |
| Health Coalition Partners | Intergroup | $268.80 | ↓ -84% |
| Multiplan | PPO | $268.80 | ↓ -84% |
| Private Health Care Systems | PPO | $268.80 | ↓ -84% |
| SelectCare | Commercial | $268.80 | ↓ -84% |
| Health Payors Organization | Commercial | $285.60 | ↓ -83% |
| Humana | Commercial | $285.60 | ↓ -83% |
| InterGroup | Approved National Affiliated PPO Business | $285.60 | ↓ -83% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $619.46 | ↓ -63% |
| UPMC Work Partners | Workers Comp | $836.39 | ↓ -50% |
| UPMC Health Plan | Commercial | $884.51 | ↓ -48% |
| AmeriHealth Caritas | Medicare | $913.97 | ↓ -46% |
| Cigna Lifesource | Medicare Transplant | $913.97 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicare | $913.97 | ↓ -46% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $913.97 | ↓ -46% |
| United Healthcare | Medicare | $913.97 | ↓ -46% |
| Aetna | Medicare | $930.90 | ↓ -45% |
| Aetna of PA | Medicare | $930.90 | ↓ -45% |
| Multiplan | Worker's Compensation | $972.55 | ↓ -42% |
| Highmark BCBS of PA | Medicare Advantage | $1,915.85 | ↑ +14% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,184.51 | ↑ +89% |
| Highmark BCBS of PA | Managed Care | $4,264.49 | ↑ +153% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,033.38 | ↑ +198% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,740.85 | ↑ +299% |
| Highmark BCBS of PA | UPMC Emergent | $8,528.98 | ↑ +405% |
Visitor-reported prices
Comments
Mopath procedure level 8 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,400.80 | $786.44 – $2,232.10 |
| UPMC Mercy | Pittsburgh | $1,687.80 | $280.95 – $1,897.78 |
| UPMC St. Margaret | Pittsburgh | $1,687.80 | $253.76 – $1,915.85 |
| UPMC Muncy | Muncy | $1,792.80 | $448.20 – $2,390.40 |
| UPMC Northwest | Seneca | $1,687.80 | $402.80 – $913.97 |
| UPMC Wellsboro | Wellsboro | $2,276.80 | $458.46 – $2,292.30 |
| UPMC Williamsport | Williamsport | $1,672.20 | $377.24 – $913.89 |