healthcosts.net
Observation per hour at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,750.20
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.
$2,917.00
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.
$27.85 with Highmark BCBS of PA vs $5,119.15 with UPMC Health Plan — 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 BCBS of PA | Medicare Advantage | $27.85 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $31.88 | ↓ -98% |
| Highmark BCBS of PA | Managed Care - Social Mission | $78.12 | ↓ -96% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $80.19 | ↓ -95% |
| Highmark BCBS of PA | Managed Care | $104.62 | ↓ -94% |
| Aetna | Medicare | $105.75 | ↓ -94% |
| Highmark BCBS of PA | Commercial - Indemnity | $107.39 | ↓ -94% |
| Highmark BCBS of PA | UPMC Emergent | $209.24 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $211.50 | ↓ -88% |
| Preferred Healthcare System | PPO | $274.95 | ↓ -84% |
| Coventry/First Health | Commercial | $296.10 | ↓ -83% |
| Fidelis | Medicare | $317.25 | ↓ -82% |
| InterGroup | InterGroup Services Corporation | $317.25 | ↓ -82% |
| Health Coalition Partners | Intergroup | $338.40 | ↓ -81% |
| Multiplan | PPO | $338.40 | ↓ -81% |
| Private Health Care Systems | PPO | $338.40 | ↓ -81% |
| SelectCare | Commercial | $338.40 | ↓ -81% |
| Health Payors Organization | Commercial | $359.55 | ↓ -79% |
| Humana | Commercial | $359.55 | ↓ -79% |
| InterGroup | Approved National Affiliated PPO Business | $359.55 | ↓ -79% |
| Aetna | CHIP/Medicaid | $1,269.50 | ↓ -27% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $2,064.00 | ↑ +18% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,137.42 | ↑ +22% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $2,137.43 | ↑ +22% |
| Geisinger | Medicaid/CHIP | $2,207.16 | ↑ +26% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2,569.10 | ↑ +47% |
| UPMC Health Plan | Commercial | $5,119.15 | ↑ +192% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Observation per hour at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $925.80 | $26.56 – $1,123.02 |
| UPMC Passavant-McCandless | Pittsburgh | $793.20 | $27.85 – $1,074.19 |
| UPMC St. Margaret | Pittsburgh | $838.80 | $27.85 – $1,074.19 |
| UPMC Muncy | Muncy | $176.40 | $44.10 – $264.60 |
| UPMC Northwest | Seneca | $443.40 | $25.00 – $1,074.19 |
| UPMC Somerset | Somerset | $111.60 | $27.31 – $139.50 |
| UPMC Wellsboro | Wellsboro | $213.60 | $48.06 – $240.30 |
| UPMC Williamsport | Williamsport | $176.40 | $79.38 – $1,372.04 |