healthcosts.net
Removal of hip foreign body 27087 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$6,864.00
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.
?
What you pay up front if you don't use insurance.
$11,440.00
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.
$71.50 with UPMC Health Plan vs $9,724.00 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 | $71.50 | ↓ -99% |
| Aetna | CHIP/Medicaid | $84.50 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $96.39 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $98.02 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $101.19 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $102.86 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $110.77 | ↓ -98% |
| Highmark BCBS of PA | Medicare Advantage | $844.93 | ↓ -88% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $864.00 | ↓ -87% |
| UPMC Health Plan | Commercial | $1,003.17 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $1,038.36 | ↓ -85% |
| Multiplan | Worker's Compensation | $1,207.39 | ↓ -82% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,094.48 | ↓ -69% |
| Highmark BCBS of PA | Managed Care | $2,804.78 | ↓ -59% |
| AmeriHealth Caritas | Medicare | $3,340.82 | ↓ -51% |
| United Healthcare | Medicare | $3,340.82 | ↓ -51% |
| Cigna Lifesource | Medicare Transplant | $3,340.82 | ↓ -51% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,340.82 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,340.82 | ↓ -51% |
| Aetna | Medicare | $3,402.68 | ↓ -50% |
| Aetna of PA | Medicare | $3,402.68 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,301.52 | ↓ -37% |
| Highmark BCBS of PA | UPMC Emergent | $5,609.55 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,760.66 | ↓ -16% |
| Preferred Healthcare System | PPO | $7,436.00 | ↑ +8% |
| Coventry/First Health | Commercial | $8,008.00 | ↑ +17% |
| Fidelis | Medicare | $8,580.00 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $8,580.00 | ↑ +25% |
| Health Coalition Partners | Intergroup | $9,152.00 | ↑ +33% |
| Private Health Care Systems | PPO | $9,152.00 | ↑ +33% |
| SelectCare | Commercial | $9,152.00 | ↑ +33% |
| Multiplan | PPO | $9,152.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $9,724.00 | ↑ +42% |
| Health Payors Organization | Commercial | $9,724.00 | ↑ +42% |
| Humana | Commercial | $9,724.00 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Removal of hip foreign body 27087 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,669.80 | $71.50 – $6,615.55 |
| UPMC Mercy | Pittsburgh | $4,678.80 | $71.50 – $7,018.20 |
| UPMC St. Margaret | Pittsburgh | $4,578.00 | $71.50 – $6,485.50 |
| UPMC Northwest | Seneca | $5,009.40 | $71.50 – $7,096.65 |
| UPMC Williamsport | Williamsport | $5,152.80 | $71.50 – $6,870.40 |