healthcosts.net
Special physics consult at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,254.00
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.
?
What you pay up front if you don't use insurance.
$2,090.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$106.15 with UPMC Health Plan vs $1,776.50 with Humana — 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 →
?
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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $106.15 | ↓ -92% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $115.80 | ↓ -91% |
| Aetna | CHIP/Medicaid | $125.45 | ↓ -90% |
| AmeriHealth Caritas | Medicare | $136.71 | ↓ -89% |
| United Healthcare | Medicare | $136.71 | ↓ -89% |
| Cigna Lifesource | Medicare Transplant | $136.71 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicare | $136.71 | ↓ -89% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $136.71 | ↓ -89% |
| Aetna | Medicare | $139.24 | ↓ -89% |
| Aetna of PA | Medicare | $139.24 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $143.11 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $145.52 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $150.22 | ↓ -88% |
| Highmark BCBS of PA | Medicare Advantage | $150.68 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $152.70 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $164.46 | ↓ -87% |
| UPMC Health Plan | Commercial | $301.59 | ↓ -76% |
| UPMC Work Partners | Workers Comp | $329.48 | ↓ -74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $373.52 | ↓ -70% |
| Multiplan | Worker's Compensation | $383.12 | ↓ -69% |
| Highmark BCBS of PA | Managed Care | $500.20 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $704.52 | ↓ -44% |
| Highmark BCBS of PA | Commercial - Indemnity | $943.52 | ↓ -25% |
| Highmark BCBS of PA | UPMC Emergent | $1,000.39 | ↓ -20% |
| Preferred Healthcare System | PPO | $1,358.50 | ↑ +8% |
| Coventry/First Health | Commercial | $1,463.00 | ↑ +17% |
| Fidelis | Medicare | $1,567.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $1,567.50 | ↑ +25% |
| Health Coalition Partners | Intergroup | $1,672.00 | ↑ +33% |
| Private Health Care Systems | PPO | $1,672.00 | ↑ +33% |
| SelectCare | Commercial | $1,672.00 | ↑ +33% |
| Multiplan | PPO | $1,672.00 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $1,776.50 | ↑ +42% |
| Health Payors Organization | Commercial | $1,776.50 | ↑ +42% |
| Humana | Commercial | $1,776.50 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Special physics consult at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $833.40 | $106.15 – $1,180.65 |
| UPMC Mercy | Pittsburgh | $1,215.00 | $105.52 – $1,822.50 |
| UPMC St. Margaret | Pittsburgh | $591.00 | $106.15 – $837.25 |
| UPMC Northwest | Seneca | $564.00 | $106.15 – $799.00 |
| UPMC Somerset | Somerset | $892.20 | $106.15 – $1,115.25 |
| UPMC Williamsport | Williamsport | $732.00 | $106.15 – $976.00 |