healthcosts.net
Shoulder MRI (with contrast) at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$8,004.00
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.
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What you pay up front if you don't use insurance.
$13,340.00
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.
$369.30 with United Healthcare Community Plan for Families vs $11,339.00 with Humana — 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 | $369.30 | ↓ -95% |
| Highmark BCBS of PA | Medicare Advantage | $544.90 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $813.49 | ↓ -90% |
| United Healthcare | Medicare | $813.49 | ↓ -90% |
| Cigna Lifesource | Medicare Transplant | $813.49 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $813.49 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $813.49 | ↓ -90% |
| Aetna | Medicare | $828.55 | ↓ -90% |
| Aetna of PA | Medicare | $828.55 | ↓ -90% |
| Premier Comp Solutions | Worker's Comp | $1,213.54 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $1,304.55 | ↓ -84% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,350.73 | ↓ -83% |
| Multiplan | Worker's Compensation | $1,516.92 | ↓ -81% |
| Highmark BCBS of PA | Managed Care | $1,808.81 | ↓ -77% |
| Aetna | CHIP/Medicaid | $2,401.20 | ↓ -70% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,547.68 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,411.97 | ↓ -57% |
| Highmark BCBS of PA | UPMC Emergent | $3,617.61 | ↓ -55% |
| UPMC Health Plan | Commercial | $6,255.13 | ↓ -22% |
| Geisinger | Medicaid/CHIP | $7,337.00 | ↓ -8% |
| Preferred Healthcare System | PPO | $8,671.00 | ↑ +8% |
| Coventry/First Health | Commercial | $9,338.00 | ↑ +17% |
| Fidelis | Medicare | $10,005.00 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $10,005.00 | ↑ +25% |
| Health Coalition Partners | Intergroup | $10,672.00 | ↑ +33% |
| Private Health Care Systems | PPO | $10,672.00 | ↑ +33% |
| SelectCare | Commercial | $10,672.00 | ↑ +33% |
| Multiplan | PPO | $10,672.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $11,339.00 | ↑ +42% |
| Health Payors Organization | Commercial | $11,339.00 | ↑ +42% |
| Humana | Commercial | $11,339.00 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder MRI (with contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,621.20 | $441.61 – $6,546.70 |
| UPMC Magee | Pittsburgh | $5,191.20 | $463.21 – $7,959.84 |
| UPMC Mercy | Pittsburgh | $5,313.60 | $439.03 – $7,970.40 |
| UPMC St. Margaret | Pittsburgh | $4,742.40 | $442.69 – $6,718.40 |
| UPMC East | Monroeville | $5,074.20 | $437.75 – $6,765.60 |
| UPMC Hamot | Erie | $1,948.80 | $201.09 – $2,273.60 |
| UPMC Horizon-Greenville | Greenville | $4,192.80 | $443.23 – $5,939.80 |
| UPMC Jameson | New Castle | $3,155.40 | $327.20 – $4,365.68 |