Rpm tx mgmt ea addl 20 min at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$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.
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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.
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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
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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 |
|---|---|---|---|
| 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
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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 |