Pcv21 vaccine im at UPMC Presbyterian

200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

$189.60

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$316.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$11.00 with UPMC Health Plan vs $977.04 with Highmark BCBS of PA — 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 →

Payer
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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
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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
UPMC Health Plan Managed Medicaid $11.00 ↓ -94%
Aetna CHIP/Medicaid $13.00 ↓ -93%
Health Partners Plans (Jefferson Health Plan) Medicaid/CHIP $15.08 ↓ -92%
Geisinger Medicaid/CHIP $15.57 ↓ -92%
AmeriHealth Caritas Community HealthChoices (CHC)/Medicaid $15.82 ↓ -92%
Aetna Medicare $79.00 ↓ -58%
UPMC Work Partners Workers Comp $103.27 ↓ -46%
Highmark BCBS of PA Medicare Advantage $116.47 ↓ -39%
Multiplan Worker's Compensation $120.08 ↓ -37%
Highmark Wholecare (prev Gateway) Medicare $158.00 ↓ -17%
Preferred Healthcare System PPO $205.40 ↑ +8%
Coventry/First Health Commercial $221.20 ↑ +17%
InterGroup InterGroup Services Corporation $237.00 ↑ +25%
Fidelis Medicare $237.00 ↑ +25%
Health Coalition Partners Intergroup $252.80 ↑ +33%
SelectCare Commercial $252.80 ↑ +33%
Multiplan PPO $252.80 ↑ +33%
Private Health Care Systems PPO $252.80 ↑ +33%
InterGroup Approved National Affiliated PPO Business $268.60 ↑ +42%
Humana Commercial $268.60 ↑ +42%
Health Payors Organization Commercial $268.60 ↑ +42%
Highmark Wholecare (prev Gateway) Medicaid $327.89 ↑ +73%
PA Health & Wellness Community Health Choices/PA Medicaid HMO $327.89 ↑ +73%
Highmark BCBS of PA Managed Care - Social Mission $364.76 ↑ +92%
Highmark BCBS of PA Commercial - Social Mission Indemnity $375.13 ↑ +98%
UPMC Health Plan Commercial $403.31 ↑ +113%
Highmark BCBS of PA Managed Care $488.52 ↑ +158%
Highmark BCBS of PA Commercial - Indemnity $502.41 ↑ +165%
Highmark BCBS of PA UPMC Emergent $977.04 ↑ +415%

Visitor-reported prices

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Pcv21 vaccine im at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Magee Pittsburgh $189.60 $11.00 – $390.69
UPMC Mercy Pittsburgh $252.80 $11.00 – $327.89
UPMC Passavant-McCandless Pittsburgh $189.60 $11.00 – $327.89
UPMC St. Margaret Pittsburgh $252.80 $11.00 – $335.40
UPMC Western Psychiatric Pittsburgh $189.60 $327.89 – $327.89
UPMC Altoona Altoona $252.80 $10.00 – $983.67
UPMC Bedford Everett $252.80 $10.50 – $327.89
UPMC Carlisle Carlisle $162.00 $12.70 – $334.45

All Pennsylvania hospitals for this procedure →