healthcosts.net
Remove renal tube w/fluoro at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$3,763.80
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.
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What you pay up front if you don't use insurance.
$6,273.00
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.
$687.26 with AmeriHealth Caritas vs $6,149.85 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 |
|---|---|---|---|
| AmeriHealth Caritas | Medicare | $687.26 | ↓ -82% |
| Cigna Lifesource | Medicare Transplant | $687.26 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicare | $687.26 | ↓ -82% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $687.26 | ↓ -82% |
| United Healthcare | Medicare | $687.26 | ↓ -82% |
| Aetna | Medicare | $699.99 | ↓ -81% |
| Aetna of PA | Medicare | $699.99 | ↓ -81% |
| Highmark BCBS of PA | Medicare Advantage | $902.01 | ↓ -76% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $931.20 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $974.58 | ↓ -74% |
| UPMC Health Plan | Commercial | $1,078.03 | ↓ -71% |
| Aetna | CHIP/Medicaid | $1,129.14 | ↓ -70% |
| Multiplan | Worker's Compensation | $1,133.23 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,235.98 | ↓ -41% |
| Highmark BCBS of PA | Managed Care | $2,994.27 | ↓ -20% |
| Geisinger | Medicaid/CHIP | $3,450.15 | ↓ -8% |
| Preferred Healthcare System | PPO | $4,077.45 | ↑ +8% |
| Coventry/First Health | Commercial | $4,391.10 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,592.13 | ↑ +22% |
| Fidelis | Medicare | $4,704.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $4,704.75 | ↑ +25% |
| Health Coalition Partners | Intergroup | $5,018.40 | ↑ +33% |
| Multiplan | PPO | $5,018.40 | ↑ +33% |
| Private Health Care Systems | PPO | $5,018.40 | ↑ +33% |
| SelectCare | Commercial | $5,018.40 | ↑ +33% |
| Health Payors Organization | Commercial | $5,332.05 | ↑ +42% |
| Humana | Commercial | $5,332.05 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $5,332.05 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $5,988.53 | ↑ +59% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,149.85 | ↑ +63% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Remove renal tube w/fluoro at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,575.00 | $591.36 – $6,481.25 |
| UPMC Mercy | Pittsburgh | $2,155.20 | $530.46 – $3,232.80 |
| UPMC St. Margaret | Pittsburgh | $2,057.40 | $549.42 – $2,914.65 |
| UPMC Northwest | Seneca | $1,830.00 | $577.11 – $2,592.50 |
| UPMC Somerset | Somerset | $3,200.40 | $629.99 – $4,000.50 |
| UPMC Williamsport | Williamsport | $621.60 | $412.22 – $993.28 |