healthcosts.net
Stent bili rx wallflx 10x80 uncvr at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$46,683.00
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.
$77,805.00
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.
$147.84 with Highmark Wholecare (prev Gateway) vs $9,062.62 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $147.84 | ↓ -100% |
| Aetna | CHIP/Medicaid | $221.76 | ↓ -100% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $234.08 | ↓ -99% |
| Aetna | Medicare | $308.00 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $406.56 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $416.79 | ↓ -99% |
| Aetna | First Health | $616.00 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $616.00 | ↓ -99% |
| Preferred Healthcare System | PPO | $800.80 | ↓ -98% |
| Coventry/First Health | Commercial | $862.40 | ↓ -98% |
| Fidelis | Medicare | $924.00 | ↓ -98% |
| InterGroup | InterGroup Services Corporation | $924.00 | ↓ -98% |
| Health Coalition Partners | Intergroup | $985.60 | ↓ -98% |
| Multiplan | PPO | $985.60 | ↓ -98% |
| Private Health Care Systems | PPO | $985.60 | ↓ -98% |
| SelectCare | Commercial | $985.60 | ↓ -98% |
| Health Payors Organization | Commercial | $1,047.20 | ↓ -98% |
| Humana | Commercial | $1,047.20 | ↓ -98% |
| InterGroup | Approved National Affiliated PPO Business | $1,047.20 | ↓ -98% |
| Highmark BCBS of PA | Medicare Advantage | $1,158.04 | ↓ -98% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,924.89 | ↓ -96% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,959.82 | ↓ -96% |
| Highmark BCBS of PA | Managed Care | $2,577.69 | ↓ -94% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,624.41 | ↓ -94% |
| Highmark BCBS of PA | UPMC Emergent | $5,155.38 | ↓ -89% |
| UPMC Health Plan | Commercial | $9,062.62 | ↓ -81% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
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Stent bili rx wallflx 10x80 uncvr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $35,011.80 | $221.52 – $4,426.11 |
| UPMC Passavant-McCandless | Pittsburgh | $33,109.80 | $109.75 – $8,133.86 |
| UPMC St. Margaret | Pittsburgh | $11,522.40 | $479.00 – $6,877.99 |
| UPMC Muncy | Muncy | $6,513.00 | $687.60 – $4,125.60 |
| UPMC Northwest | Seneca | $3,802.20 | $1,584.25 – $6,782.80 |
| UPMC Somerset | Somerset | $6,966.60 | $596.80 – $3,357.32 |
| UPMC Wellsboro | Wellsboro | $7,876.80 | $748.44 – $3,742.20 |
| UPMC Williamsport | Williamsport | $33,391.20 | $437.60 – $1,969.20 |