Off/op consltj new/est hi 55 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$3,681.60
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.
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What you pay up front if you don't use insurance.
$6,136.00
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.
$142.11 with Highmark BCBS of PA vs $5,215.60 with Health Payors Organization — 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 | $142.11 | ↓ -96% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $170.36 | ↓ -95% |
| Highmark BCBS of PA | Managed Care - Social Mission | $264.21 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $271.72 | ↓ -93% |
| Highmark BCBS of PA | Managed Care | $353.86 | ↓ -90% |
| UPMC Health Plan | Commercial | $356.68 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Indemnity | $363.92 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $385.74 | ↓ -90% |
| Multiplan | Worker's Compensation | $448.53 | ↓ -88% |
| Highmark BCBS of PA | UPMC Emergent | $707.72 | ↓ -81% |
| Aetna | CHIP/Medicaid | $1,104.48 | ↓ -70% |
| Aetna | Medicare | $1,534.00 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,068.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $3,374.80 | ↓ -8% |
| Preferred Healthcare System | PPO | $3,988.40 | ↑ +8% |
| Coventry/First Health | Commercial | $4,295.20 | ↑ +17% |
| Fidelis | Medicare | $4,602.00 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $4,602.00 | ↑ +25% |
| SelectCare | Commercial | $4,908.80 | ↑ +33% |
| Private Health Care Systems | PPO | $4,908.80 | ↑ +33% |
| Multiplan | PPO | $4,908.80 | ↑ +33% |
| Health Coalition Partners | Intergroup | $4,908.80 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $5,215.60 | ↑ +42% |
| Humana | Commercial | $5,215.60 | ↑ +42% |
| Health Payors Organization | Commercial | $5,215.60 | ↑ +42% |
Visitor-reported prices
Comments
Off/op consltj new/est hi 55 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $1,018.80 | $142.11 – $406.72 |
| UPMC Cole | Coudersport | $655.20 | $168.00 – $488.80 |
| UPMC Community Osteopathic | Harrisburg | $659.40 | $108.80 – $753.18 |
| UPMC Somerset | Somerset | $659.40 | $26.11 – $348.71 |
| UPMC Wellsboro | Wellsboro | $333.00 | $181.72 – $348.71 |