Rpm tx mgmt ea addl 20 min 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

$238.80

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.

Full explanation →

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

$398.00

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.

Full explanation →

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

$22.08 with United Healthcare Community Plan for Families vs $338.30 with Health Payors Organization — 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 →

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
United Healthcare Community Plan for Families PA CHIP/PA Medicaid $22.08 ↓ -91%
Highmark BCBS of PA Medicare Advantage $23.16 ↓ -90%
Aetna of PA Medicare $36.08 ↓ -85%
UPMC Work Partners Workers Comp $54.13 ↓ -77%
Multiplan Worker's Compensation $62.94 ↓ -74%
Aetna CHIP/Medicaid $71.64 ↓ -70%
Highmark BCBS of PA Managed Care - Social Mission $72.52 ↓ -70%
Highmark BCBS of PA Commercial - Social Mission Indemnity $74.58 ↓ -69%
Highmark BCBS of PA Managed Care $97.12 ↓ -59%
Aetna Medicare $99.50 ↓ -58%
Highmark BCBS of PA Commercial - Indemnity $99.88 ↓ -58%
UPMC Health Plan Commercial $186.62 ↓ -22%
Highmark BCBS of PA UPMC Emergent $194.24 ↓ -19%
Highmark Wholecare (prev Gateway) Medicare $199.00 ↓ -17%
Geisinger Medicaid/CHIP $218.90 ↓ -8%
Preferred Healthcare System PPO $258.70 ↑ +8%
Coventry/First Health Commercial $278.60 ↑ +17%
Fidelis Medicare $298.50 ↑ +25%
InterGroup InterGroup Services Corporation $298.50 ↑ +25%
Multiplan PPO $318.40 ↑ +33%
Private Health Care Systems PPO $318.40 ↑ +33%
Health Coalition Partners Intergroup $318.40 ↑ +33%
SelectCare Commercial $318.40 ↑ +33%
InterGroup Approved National Affiliated PPO Business $338.30 ↑ +42%
Humana Commercial $338.30 ↑ +42%
Health Payors Organization Commercial $338.30 ↑ +42%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Rpm tx mgmt ea addl 20 min at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Mercy Pittsburgh $158.40 $22.94 – $54.13
UPMC Passavant-McCandless Pittsburgh $156.60 $23.16 – $57.53
UPMC St. Margaret Pittsburgh $166.20 $23.16 – $49.48
UPMC Horizon-Greenville Greenville $168.60 $49.48 – $71.34
UPMC Williamsport Williamsport $176.40 $23.55 – $54.65

All Pennsylvania hospitals for this procedure →