Opn exc/dst ntra-abd 10.1-20 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$22,682.40
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.
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What you pay up front if you don't use insurance.
$37,804.00
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.
$670.85 with Highmark BCBS of PA vs $32,133.40 with InterGroup — 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 | $670.85 | ↓ -97% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,662.95 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $1,994.70 | ↓ -91% |
| Highmark BCBS of PA | Managed Care | $2,226.90 | ↓ -90% |
| Multiplan | Worker's Compensation | $2,319.42 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,415.27 | ↓ -85% |
| Highmark BCBS of PA | UPMC Emergent | $4,453.81 | ↓ -80% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,573.78 | ↓ -80% |
| Aetna | CHIP/Medicaid | $6,804.72 | ↓ -70% |
| Aetna | Medicare | $9,451.00 | ↓ -58% |
| UPMC Health Plan | Commercial | $17,726.30 | ↓ -22% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,902.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $20,792.20 | ↓ -8% |
| Preferred Healthcare System | PPO | $24,572.60 | ↑ +8% |
| Coventry/First Health | Commercial | $26,462.80 | ↑ +17% |
| Fidelis | Medicare | $28,353.00 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $28,353.00 | ↑ +25% |
| SelectCare | Commercial | $30,243.20 | ↑ +33% |
| Multiplan | PPO | $30,243.20 | ↑ +33% |
| Private Health Care Systems | PPO | $30,243.20 | ↑ +33% |
| Health Coalition Partners | Intergroup | $30,243.20 | ↑ +33% |
| Humana | Commercial | $32,133.40 | ↑ +42% |
| Health Payors Organization | Commercial | $32,133.40 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $32,133.40 | ↑ +42% |
Visitor-reported prices
Comments
Opn exc/dst ntra-abd 10.1-20 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $8,653.20 | $1,907.19 – $12,258.70 |
| UPMC Community Osteopathic | Harrisburg | $8,653.20 | $1,052.00 – $4,471.00 |
| UPMC Hanover | Hanover | $8,653.20 | $1,907.19 – $1,907.19 |
| UPMC Horizon-Greenville | Greenville | $12,047.40 | $1,292.79 – $1,822.43 |
| UPMC Lititz | Lititz | $8,653.20 | $1,775.20 – $1,907.19 |
| UPMC Memorial | York | $8,653.20 | $541.61 – $1,907.19 |
| UPMC Somerset | Somerset | $8,653.20 | $657.80 – $1,822.43 |