healthcosts.net
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$3,154.80
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.
?
What you pay up front if you don't use insurance.
$5,258.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$77.78 with UPMC Health Plan vs $4,469.30 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $77.78 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $84.85 | ↓ -97% |
| Aetna | CHIP/Medicaid | $91.92 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $104.86 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $106.63 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $110.07 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $111.89 | ↓ -96% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $120.50 | ↓ -96% |
| Highmark BCBS of PA | Medicare Advantage | $327.96 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $709.95 | ↓ -77% |
| AmeriHealth Caritas | Medicare | $724.45 | ↓ -77% |
| United Healthcare | Medicare | $724.45 | ↓ -77% |
| Cigna Lifesource | Medicare Transplant | $724.45 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicare | $724.45 | ↓ -77% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $724.45 | ↓ -77% |
| Aetna | Medicare | $737.87 | ↓ -77% |
| Aetna of PA | Medicare | $737.87 | ↓ -77% |
| UPMC Health Plan | Commercial | $793.00 | ↓ -75% |
| Highmark BCBS of PA | Managed Care - Social Mission | $812.96 | ↓ -74% |
| Multiplan | Worker's Compensation | $825.52 | ↓ -74% |
| Highmark BCBS of PA | Managed Care | $1,088.66 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,669.61 | ↓ -47% |
| Highmark BCBS of PA | UPMC Emergent | $2,177.32 | ↓ -31% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,235.97 | ↓ -29% |
| Preferred Healthcare System | PPO | $3,417.70 | ↑ +8% |
| Coventry/First Health | Commercial | $3,680.60 | ↑ +17% |
| Fidelis | Medicare | $3,943.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $3,943.50 | ↑ +25% |
| Health Coalition Partners | Intergroup | $4,206.40 | ↑ +33% |
| Private Health Care Systems | PPO | $4,206.40 | ↑ +33% |
| SelectCare | Commercial | $4,206.40 | ↑ +33% |
| Multiplan | PPO | $4,206.40 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $4,469.30 | ↑ +42% |
| Health Payors Organization | Commercial | $4,469.30 | ↑ +42% |
| Humana | Commercial | $4,469.30 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,891.40 | $77.78 – $8,346.15 |
| UPMC St. Margaret | Pittsburgh | $1,564.20 | $77.78 – $2,215.95 |
| UPMC Muncy | Muncy | $946.80 | $77.78 – $1,262.40 |
| UPMC Northwest | Seneca | $1,593.00 | $77.78 – $2,256.75 |
| UPMC Somerset | Somerset | $1,162.20 | $77.78 – $1,452.75 |
| UPMC Wellsboro | Wellsboro | $1,144.80 | $77.78 – $1,287.90 |
| UPMC Williamsport | Williamsport | $946.80 | $77.78 – $1,262.40 |