healthcosts.net
Perq dev breast 1st strtctc at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
not published by hospital
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.
not published by hospital
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.
$91.72 with UPMC Health Plan vs $1,338.23 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 →
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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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $91.72 | — |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $100.06 | — |
| Aetna | CHIP/Medicaid | $108.39 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $123.65 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $125.74 | — |
| Geisinger | Medicaid/CHIP | $129.80 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $131.94 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $142.10 | — |
| Highmark BCBS of PA | Medicare Advantage | $196.28 | — |
| UPMC Work Partners | Workers Comp | $418.65 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $486.56 | — |
| Multiplan | Worker's Compensation | $486.80 | — |
| Highmark BCBS of PA | Managed Care | $651.56 | — |
| AmeriHealth Caritas | Medicare | $724.45 | — |
| Cigna Lifesource | Medicare Transplant | $724.45 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $724.45 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $724.45 | — |
| United Healthcare | Medicare | $724.45 | — |
| Aetna | Medicare | $737.87 | — |
| Aetna of PA | Medicare | $737.87 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $999.26 | — |
| UPMC Health Plan | Commercial | $1,118.46 | — |
| Highmark BCBS of PA | UPMC Emergent | $1,303.13 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $1,338.23 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Perq dev breast 1st strtctc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Muncy | Muncy | $1,793.40 | $91.72 – $2,391.20 |
| UPMC Northwest | Seneca | $1,787.40 | $91.72 – $2,532.15 |
| UPMC Somerset | Somerset | $924.60 | $91.72 – $1,155.75 |
| UPMC Wellsboro | Wellsboro | $2,168.80 | $91.72 – $2,439.90 |
| UPMC Williamsport | Williamsport | $1,793.40 | $91.72 – $2,391.20 |