Opn exc/dstr ntra-abd 5.1-10 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$19,815.00
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.
$33,025.00
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.
$561.58 with Highmark BCBS of PA vs $28,071.25 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 | $561.58 | ↓ -97% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,392.08 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $1,669.27 | ↓ -92% |
| Highmark BCBS of PA | Managed Care | $1,864.18 | ↓ -91% |
| Multiplan | Worker's Compensation | $1,941.01 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,858.99 | ↓ -86% |
| Highmark BCBS of PA | UPMC Emergent | $3,728.37 | ↓ -81% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,828.80 | ↓ -81% |
| Aetna | CHIP/Medicaid | $5,944.50 | ↓ -70% |
| Aetna | Medicare | $8,256.25 | ↓ -58% |
| UPMC Health Plan | Commercial | $15,485.42 | ↓ -22% |
| Highmark Wholecare (prev Gateway) | Medicare | $16,512.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $18,163.75 | ↓ -8% |
| Preferred Healthcare System | PPO | $21,466.25 | ↑ +8% |
| Coventry/First Health | Commercial | $23,117.50 | ↑ +17% |
| Fidelis | Medicare | $24,768.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $24,768.75 | ↑ +25% |
| SelectCare | Commercial | $26,420.00 | ↑ +33% |
| Multiplan | PPO | $26,420.00 | ↑ +33% |
| Private Health Care Systems | PPO | $26,420.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $26,420.00 | ↑ +33% |
| Humana | Commercial | $28,071.25 | ↑ +42% |
| Health Payors Organization | Commercial | $28,071.25 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $28,071.25 | ↑ +42% |
Visitor-reported prices
Comments
Opn exc/dstr ntra-abd 5.1-10 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $8,653.20 | $1,596.46 – $12,258.70 |
| UPMC Community Osteopathic | Harrisburg | $8,653.20 | $1,052.00 – $4,471.00 |
| UPMC Hanover | Hanover | $8,653.20 | $1,596.46 – $1,596.46 |
| UPMC Horizon-Greenville | Greenville | $10,524.60 | $1,082.22 – $1,525.51 |
| UPMC Lititz | Lititz | $8,653.20 | $1,486.05 – $1,596.46 |
| UPMC Memorial | York | $8,653.20 | $453.39 – $1,596.46 |
| UPMC Somerset | Somerset | $8,653.20 | $550.66 – $1,525.51 |