healthcosts.net
Target gsa panel organ/hmtlmph neop at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$9,920.40
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.
$16,534.00
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.
$1,869.20 with Highmark BCBS of PA vs $11,330.19 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 BCBS of PA | Medicare Advantage | $1,869.20 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $2,335.68 | ↓ -76% |
| UPMC Health Plan | Managed Medicaid | $2,569.25 | ↓ -74% |
| Preferred Healthcare System | PPO | $2,629.25 | ↓ -73% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $2,802.82 | ↓ -72% |
| Coventry/First Health | Commercial | $2,831.50 | ↓ -71% |
| UPMC Work Partners | Workers Comp | $2,885.51 | ↓ -71% |
| Fidelis | Medicare | $3,033.75 | ↓ -69% |
| InterGroup | InterGroup Services Corporation | $3,033.75 | ↓ -69% |
| Aetna | CHIP/Medicaid | $3,036.38 | ↓ -69% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,106.97 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $3,153.17 | ↓ -68% |
| United Healthcare | Medicare | $3,153.17 | ↓ -68% |
| Cigna Lifesource | Medicare Transplant | $3,153.17 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,153.17 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,153.17 | ↓ -68% |
| Aetna | Medicare | $3,211.56 | ↓ -68% |
| Aetna of PA | Medicare | $3,211.56 | ↓ -68% |
| Health Coalition Partners | Intergroup | $3,236.00 | ↓ -67% |
| Private Health Care Systems | PPO | $3,236.00 | ↓ -67% |
| SelectCare | Commercial | $3,236.00 | ↓ -67% |
| Multiplan | PPO | $3,236.00 | ↓ -67% |
| Multiplan | Worker's Compensation | $3,355.24 | ↓ -66% |
| InterGroup | Approved National Affiliated PPO Business | $3,438.25 | ↓ -65% |
| Health Payors Organization | Commercial | $3,438.25 | ↓ -65% |
| Humana | Commercial | $3,438.25 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicaid | $3,463.81 | ↓ -65% |
| Geisinger | Medicaid/CHIP | $3,635.95 | ↓ -63% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3,695.98 | ↓ -63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,980.47 | ↓ -60% |
| Highmark BCBS of PA | Managed Care | $4,160.65 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,910.82 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,576.72 | ↓ -34% |
| Highmark BCBS of PA | UPMC Emergent | $8,321.30 | ↓ -16% |
| UPMC Health Plan | Commercial | $11,330.19 | ↑ +14% |
Visitor-reported prices
Comments
Target gsa panel organ/hmtlmph neop at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $8,669.40 | $1,375.30 – $3,438.25 |
| UPMC Mercy | Pittsburgh | $5,739.00 | $1,851.57 – $8,608.50 |
| UPMC St. Margaret | Pittsburgh | $5,739.00 | $1,869.20 – $8,130.25 |
| UPMC Northwest | Seneca | $5,739.00 | $1,618.00 – $3,438.25 |
| UPMC Wellsboro | Wellsboro | $5,631.60 | $1,689.48 – $8,447.40 |
| UPMC Williamsport | Williamsport | $5,526.00 | $2,569.25 – $7,368.00 |