healthcosts.net
Mr safety determination physician/other qhp at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$215.40
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.
$359.00
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.
$14.49 with Highmark BCBS of PA vs $305.15 with InterGroup — 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 | $14.49 | ↓ -93% |
| Highmark BCBS of PA | Managed Care - Social Mission | $35.91 | ↓ -83% |
| Highmark BCBS of PA | Managed Care | $48.09 | ↓ -78% |
| Aetna | CHIP/Medicaid | $64.62 | ↓ -70% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $67.73 | ↓ -69% |
| UPMC Work Partners | Workers Comp | $72.46 | ↓ -66% |
| Multiplan | Worker's Compensation | $84.26 | ↓ -61% |
| Aetna | Medicare | $89.75 | ↓ -58% |
| AmeriHealth Caritas | Medicare | $90.67 | ↓ -58% |
| Cigna Lifesource | Medicare Transplant | $90.67 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicare | $90.67 | ↓ -58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.67 | ↓ -58% |
| United Healthcare | Medicare | $90.67 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity | $90.71 | ↓ -58% |
| Aetna of PA | Medicare | $92.34 | ↓ -57% |
| Highmark BCBS of PA | UPMC Emergent | $96.18 | ↓ -55% |
| UPMC Health Plan | Commercial | $168.34 | ↓ -22% |
| Geisinger | Medicaid/CHIP | $197.45 | ↓ -8% |
| Preferred Healthcare System | PPO | $233.35 | ↑ +8% |
| Coventry/First Health | Commercial | $251.30 | ↑ +17% |
| Fidelis | Medicare | $269.25 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $269.25 | ↑ +25% |
| Health Coalition Partners | Intergroup | $287.20 | ↑ +33% |
| Multiplan | PPO | $287.20 | ↑ +33% |
| Private Health Care Systems | PPO | $287.20 | ↑ +33% |
| SelectCare | Commercial | $287.20 | ↑ +33% |
| Health Payors Organization | Commercial | $305.15 | ↑ +42% |
| Humana | Commercial | $305.15 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $305.15 | ↑ +42% |
Visitor-reported prices
Comments
Mr safety determination physician/other qhp at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $161.40 | $32.25 – $228.65 |
| UPMC Mercy | Pittsburgh | $161.40 | $14.35 – $242.10 |
| UPMC St. Margaret | Pittsburgh | $161.40 | $32.25 – $228.65 |
| UPMC Muncy | Muncy | $160.20 | $40.05 – $213.60 |
| UPMC Northwest | Seneca | $161.40 | $37.24 – $228.65 |
| UPMC Somerset | Somerset | $161.40 | $14.20 – $201.75 |
| UPMC Wellsboro | Wellsboro | $160.20 | $48.06 – $240.30 |
| UPMC Williamsport | Williamsport | $160.20 | $65.26 – $213.60 |