healthcosts.net
St analysis behavior qualitative voice/resonance at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$393.00
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.
$655.00
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.
$69.79 with Highmark BCBS of PA vs $556.75 with InterGroup — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare Advantage | $69.79 | ↓ -82% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $89.96 | ↓ -77% |
| Highmark BCBS of PA | Managed Care - Social Mission | $116.00 | ↓ -70% |
| Aetna | CHIP/Medicaid | $117.90 | ↓ -70% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $118.10 | ↓ -70% |
| UPMC Work Partners | Workers Comp | $143.13 | ↓ -64% |
| Highmark BCBS of PA | Managed Care | $155.34 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Indemnity | $158.15 | ↓ -60% |
| Aetna | Medicare | $163.75 | ↓ -58% |
| Multiplan | Worker's Compensation | $166.43 | ↓ -58% |
| Highmark BCBS of PA | UPMC Emergent | $310.68 | ↓ -21% |
| Highmark Wholecare (prev Gateway) | Medicare | $327.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $360.25 | ↓ -8% |
| UPMC Health Plan | Commercial | $423.10 | ↑ +8% |
| Preferred Healthcare System | PPO | $425.75 | ↑ +8% |
| Coventry/First Health | Commercial | $458.50 | ↑ +17% |
| Fidelis | Medicare | $491.25 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $491.25 | ↑ +25% |
| Health Coalition Partners | Intergroup | $524.00 | ↑ +33% |
| Multiplan | PPO | $524.00 | ↑ +33% |
| Private Health Care Systems | PPO | $524.00 | ↑ +33% |
| SelectCare | Commercial | $524.00 | ↑ +33% |
| Health Payors Organization | Commercial | $556.75 | ↑ +42% |
| Humana | Commercial | $556.75 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $556.75 | ↑ +42% |
Visitor-reported prices
Comments
St analysis behavior qualitative voice/resonance at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $228.60 | $69.13 – $342.90 |
| UPMC Passavant-McCandless | Pittsburgh | $429.60 | $69.79 – $608.60 |
| UPMC St. Margaret | Pittsburgh | $239.40 | $69.79 – $339.15 |
| UPMC Muncy | Muncy | $310.20 | $77.55 – $413.60 |
| UPMC Northwest | Seneca | $404.40 | $131.64 – $572.90 |
| UPMC Somerset | Somerset | $435.00 | $68.43 – $543.75 |
| UPMC Wellsboro | Wellsboro | $375.20 | $84.42 – $422.10 |
| UPMC Williamsport | Williamsport | $310.20 | $95.96 – $413.60 |