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Tc-99m exametazime diag at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$8,173.20
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.
$13,622.00
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.
$866.53 with AmeriHealth Caritas vs $14,019.41 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Medicare | $866.53 | ↓ -89% |
| Cigna Lifesource | Medicare Transplant | $866.53 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicare | $866.53 | ↓ -89% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $866.53 | ↓ -89% |
| United Healthcare | Medicare | $866.53 | ↓ -89% |
| Aetna | Medicare | $882.57 | ↓ -89% |
| Aetna of PA | Medicare | $882.57 | ↓ -89% |
| Highmark BCBS of PA | Medicare Advantage | $1,671.27 | ↓ -80% |
| Aetna | CHIP/Medicaid | $2,451.96 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $5,233.88 | ↓ -36% |
| UPMC Health Plan | Commercial | $5,288.01 | ↓ -35% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,382.70 | ↓ -34% |
| Highmark BCBS of PA | Managed Care | $7,009.70 | ↓ -14% |
| Highmark BCBS of PA | Commercial - Indemnity | $7,209.03 | ↓ -12% |
| Geisinger | Medicaid/CHIP | $7,492.10 | ↓ -8% |
| Preferred Healthcare System | PPO | $8,854.30 | ↑ +8% |
| Coventry/First Health | Commercial | $9,535.40 | ↑ +17% |
| Fidelis | Medicare | $10,216.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $10,216.50 | ↑ +25% |
| Health Coalition Partners | Intergroup | $10,897.60 | ↑ +33% |
| Multiplan | PPO | $10,897.60 | ↑ +33% |
| Private Health Care Systems | PPO | $10,897.60 | ↑ +33% |
| SelectCare | Commercial | $10,897.60 | ↑ +33% |
| Health Payors Organization | Commercial | $11,578.70 | ↑ +42% |
| Humana | Commercial | $11,578.70 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $11,578.70 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $14,019.41 | ↑ +72% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Tc-99m exametazime diag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,733.20 | $745.61 – $5,288.70 |
| UPMC St. Margaret | Pittsburgh | $1,461.00 | $613.62 – $2,069.75 |
| UPMC Northwest | Seneca | $1,750.20 | $727.64 – $2,479.45 |
| UPMC Wellsboro | Wellsboro | $867.20 | $195.12 – $975.60 |
| UPMC Williamsport | Williamsport | $717.00 | $475.49 – $1,075.50 |