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System pacing micra av at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$45,109.20
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.
$75,182.00
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.
$1,201.56 with Highmark Wholecare (prev Gateway) vs $21,161.84 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 | $1,201.56 | ↓ -97% |
| Aetna | CHIP/Medicaid | $1,710.00 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1,902.47 | ↓ -96% |
| Aetna | Medicare | $2,375.00 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $3,304.29 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3,387.40 | ↓ -92% |
| Highmark BCBS of PA | Medicare Advantage | $3,424.88 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,750.00 | ↓ -89% |
| Aetna | First Health | $5,006.50 | ↓ -89% |
| Highmark BCBS of PA | Managed Care - Social Mission | $5,692.79 | ↓ -87% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,796.10 | ↓ -87% |
| Preferred Healthcare System | PPO | $6,175.00 | ↓ -86% |
| Coventry/First Health | Commercial | $6,650.00 | ↓ -85% |
| Fidelis | Medicare | $7,125.00 | ↓ -84% |
| InterGroup | InterGroup Services Corporation | $7,125.00 | ↓ -84% |
| Health Coalition Partners | Intergroup | $7,600.00 | ↓ -83% |
| Multiplan | PPO | $7,600.00 | ↓ -83% |
| Private Health Care Systems | PPO | $7,600.00 | ↓ -83% |
| SelectCare | Commercial | $7,600.00 | ↓ -83% |
| Highmark BCBS of PA | Managed Care | $7,623.43 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity | $7,761.59 | ↓ -83% |
| Health Payors Organization | Commercial | $8,075.00 | ↓ -82% |
| Humana | Commercial | $8,075.00 | ↓ -82% |
| InterGroup | Approved National Affiliated PPO Business | $8,075.00 | ↓ -82% |
| Highmark BCBS of PA | UPMC Emergent | $15,246.85 | ↓ -66% |
| UPMC Health Plan | Commercial | $21,161.84 | ↓ -53% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
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System pacing micra av at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $28,759.80 | $3,392.57 – $17,916.30 |
| UPMC Passavant-McCandless | Pittsburgh | $30,110.40 | $2,375.00 – $18,993.11 |
| UPMC Northwest | Seneca | $6,175.20 | $2,573.00 – $15,838.31 |
| UPMC Somerset | Somerset | $9,256.80 | $3,085.60 – $11,571.00 |
| UPMC Williamsport | Williamsport | $22,146.00 | $0.20 – $0.90 |