healthcosts.net
Shunt glaucoma baerveldt 350mm at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$10,690.80
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.
$17,818.00
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.
$369.00 with Aetna vs $9,351.81 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $369.00 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $442.56 | ↓ -96% |
| Highmark BCBS of PA | Medicare Advantage | $489.17 | ↓ -95% |
| Aetna | Medicare | $512.50 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $700.72 | ↓ -93% |
| Highmark BCBS of PA | Managed Care - Social Mission | $813.09 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $827.84 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,025.00 | ↓ -90% |
| Highmark BCBS of PA | Managed Care | $1,088.83 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,108.57 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $1,127.50 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,247.65 | ↓ -88% |
| Preferred Healthcare System | PPO | $1,332.50 | ↓ -88% |
| Coventry/First Health | Commercial | $1,435.00 | ↓ -87% |
| Fidelis | Medicare | $1,537.50 | ↓ -86% |
| InterGroup | InterGroup Services Corporation | $1,537.50 | ↓ -86% |
| Health Coalition Partners | Intergroup | $1,640.00 | ↓ -85% |
| Multiplan | PPO | $1,640.00 | ↓ -85% |
| Private Health Care Systems | PPO | $1,640.00 | ↓ -85% |
| SelectCare | Commercial | $1,640.00 | ↓ -85% |
| Health Payors Organization | Commercial | $1,742.50 | ↓ -84% |
| Humana | Commercial | $1,742.50 | ↓ -84% |
| InterGroup | Approved National Affiliated PPO Business | $1,742.50 | ↓ -84% |
| Aetna | First Health | $1,844.00 | ↓ -83% |
| Highmark BCBS of PA | UPMC Emergent | $2,177.67 | ↓ -80% |
| UPMC Health Plan | Commercial | $9,351.81 | ↓ -13% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Shunt glaucoma baerveldt 350mm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $5,882.40 | $484.55 – $4,567.35 |
| UPMC Passavant-McCandless | Pittsburgh | $5,235.60 | $489.17 – $8,393.41 |
| UPMC St. Margaret | Pittsburgh | $4,636.80 | $489.17 – $7,097.47 |
| UPMC Muncy | Muncy | $5,572.20 | $343.35 – $2,060.10 |
| UPMC Northwest | Seneca | $4,636.80 | $1,257.60 – $6,999.24 |
| UPMC Wellsboro | Wellsboro | $6,739.20 | $491.94 – $2,459.70 |