healthcosts.net
Passy muir valve metal trach at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,261.20
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.
$2,102.00
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.
$55.20 with Highmark Wholecare (prev Gateway) vs $774.13 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 Wholecare (prev Gateway) | Medicaid | $55.20 | ↓ -96% |
| Aetna | CHIP/Medicaid | $82.80 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $87.40 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $90.00 | ↓ -93% |
| Aetna | Medicare | $115.00 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $151.80 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $155.62 | ↓ -88% |
| Highmark BCBS of PA | Medicare Advantage | $157.36 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $222.54 | ↓ -82% |
| Aetna | First Health | $230.00 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicare | $230.00 | ↓ -82% |
| Multiplan | Worker's Compensation | $258.77 | ↓ -79% |
| Highmark BCBS of PA | Managed Care - Social Mission | $261.57 | ↓ -79% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $266.31 | ↓ -79% |
| Preferred Healthcare System | PPO | $299.00 | ↓ -76% |
| Coventry/First Health | Commercial | $322.00 | ↓ -74% |
| Fidelis | Medicare | $345.00 | ↓ -73% |
| InterGroup | InterGroup Services Corporation | $345.00 | ↓ -73% |
| Highmark BCBS of PA | Managed Care | $350.27 | ↓ -72% |
| Highmark BCBS of PA | Commercial - Indemnity | $356.62 | ↓ -72% |
| Health Coalition Partners | Intergroup | $368.00 | ↓ -71% |
| Multiplan | PPO | $368.00 | ↓ -71% |
| Private Health Care Systems | PPO | $368.00 | ↓ -71% |
| SelectCare | Commercial | $368.00 | ↓ -71% |
| Health Payors Organization | Commercial | $391.00 | ↓ -69% |
| Humana | Commercial | $391.00 | ↓ -69% |
| InterGroup | Approved National Affiliated PPO Business | $391.00 | ↓ -69% |
| Highmark BCBS of PA | UPMC Emergent | $700.55 | ↓ -44% |
| UPMC Health Plan | Commercial | $774.13 | ↓ -39% |
Visitor-reported prices
Comments
Passy muir valve metal trach at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $241.20 | $96.48 – $378.08 |
| UPMC Passavant-McCandless | Pittsburgh | $1,018.20 | $157.36 – $1,442.45 |
| UPMC Muncy | Muncy | $289.80 | $72.45 – $386.40 |
| UPMC Northwest | Seneca | $346.20 | $144.25 – $579.39 |
| UPMC Wellsboro | Wellsboro | $350.40 | $78.84 – $394.20 |
| UPMC Williamsport | Williamsport | $289.80 | $96.00 – $386.40 |