healthcosts.net
Stent iliac/open/perc/ea ad/ipsila 37223 at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$24,101.40
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.
$40,169.00
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.
$198.55 with UPMC Health Plan vs $34,143.65 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $198.55 | ↓ -99% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $216.60 | ↓ -99% |
| Aetna | CHIP/Medicaid | $234.65 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $267.68 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $272.19 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $280.98 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $285.62 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $307.61 | ↓ -99% |
| UPMC Health Plan | Commercial | $3,326.67 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $4,277.12 | ↓ -82% |
| Highmark BCBS of PA | Medicare Advantage | $4,658.60 | ↓ -81% |
| Multiplan | Worker's Compensation | $4,973.39 | ↓ -79% |
| Aetna | Medicare | $10,042.25 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $11,548.06 | ↓ -52% |
| Highmark BCBS of PA | Managed Care | $15,464.36 | ↓ -36% |
| Highmark Wholecare (prev Gateway) | Medicare | $20,084.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $23,716.77 | ↓ -2% |
| Preferred Healthcare System | PPO | $26,109.85 | ↑ +8% |
| Coventry/First Health | Commercial | $28,118.30 | ↑ +17% |
| Fidelis | Medicare | $30,126.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $30,126.75 | ↑ +25% |
| Highmark BCBS of PA | UPMC Emergent | $30,928.73 | ↑ +28% |
| Highmark BCBS of PA | Commercial - Indemnity | $31,761.89 | ↑ +32% |
| Health Coalition Partners | Intergroup | $32,135.20 | ↑ +33% |
| Multiplan | PPO | $32,135.20 | ↑ +33% |
| Private Health Care Systems | PPO | $32,135.20 | ↑ +33% |
| SelectCare | Commercial | $32,135.20 | ↑ +33% |
| Health Payors Organization | Commercial | $34,143.65 | ↑ +42% |
| Humana | Commercial | $34,143.65 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $34,143.65 | ↑ +42% |
Visitor-reported prices
Comments
Stent iliac/open/perc/ea ad/ipsila 37223 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $18,360.00 | $3,788.30 – $26,010.00 |
| UPMC Mercy | Pittsburgh | $16,416.00 | $198.55 – $24,624.00 |
| UPMC St. Margaret | Pittsburgh | $16,830.00 | $3,788.30 – $23,842.50 |
| UPMC Northwest | Seneca | $16,307.40 | $3,788.30 – $23,102.15 |
| UPMC Somerset | Somerset | $8,640.60 | $207.57 – $10,800.75 |
| UPMC Williamsport | Williamsport | $7,915.20 | $231.04 – $10,553.60 |