Oth resp proc, indiv at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$66.00
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.
$110.00
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.
$13.89 with Highmark BCBS of PA vs $93.50 with Humana — 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 | $13.89 | ↓ -79% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $18.28 | ↓ -72% |
| Aetna | CHIP/Medicaid | $19.80 | ↓ -70% |
| Highmark Wholecare (prev Gateway) | Medicare | $25.22 | ↓ -62% |
| AmeriHealth Caritas | Medicare | $25.22 | ↓ -62% |
| Cigna Lifesource | Medicare Transplant | $25.22 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $25.22 | ↓ -62% |
| United Healthcare | Medicare | $25.22 | ↓ -62% |
| Aetna of PA | Medicare | $25.68 | ↓ -61% |
| Aetna | Medicare | $25.68 | ↓ -61% |
| Highmark BCBS of PA | Managed Care - Social Mission | $34.42 | ↓ -48% |
| Highmark BCBS of PA | Managed Care | $46.10 | ↓ -30% |
| Geisinger | Medicaid/CHIP | $60.50 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $64.72 | ↓ -2% |
| Preferred Healthcare System | PPO | $71.50 | ↑ +8% |
| UPMC Health Plan | Commercial | $73.34 | ↑ +11% |
| Coventry/First Health | Commercial | $77.00 | ↑ +17% |
| Fidelis | Medicare | $82.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $82.50 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Indemnity | $86.67 | ↑ +31% |
| Multiplan | PPO | $88.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $88.00 | ↑ +33% |
| Private Health Care Systems | PPO | $88.00 | ↑ +33% |
| SelectCare | Commercial | $88.00 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $92.19 | ↑ +40% |
| Health Payors Organization | Commercial | $93.50 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $93.50 | ↑ +42% |
| Humana | Commercial | $93.50 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Oth resp proc, indiv at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $81.60 | $13.89 – $25.68 |
| UPMC Passavant-McCandless | Pittsburgh | $79.80 | $13.89 – $25.68 |
| UPMC Altoona | Altoona | $100.80 | $13.76 – $134.40 |
| UPMC Bedford | Everett | $84.60 | $8.42 – $126.90 |
| UPMC Community Osteopathic | Harrisburg | $54.60 | $18.20 – $77.35 |
| UPMC Hamot | Erie | $80.40 | $13.76 – $25.46 |
| UPMC Hanover | Hanover | $54.60 | $19.95 – $45.36 |
| UPMC Horizon-Greenville | Greenville | $39.00 | $20.91 – $33.36 |