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Tc-99m mebrofenin at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,143.60
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.
$1,906.00
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.
$101.07 with Highmark BCBS of PA vs $1,620.10 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare Advantage | $101.07 | ↓ -91% |
| Highmark BCBS of PA | Managed Care - Social Mission | $316.51 | ↓ -72% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $325.51 | ↓ -72% |
| Aetna | CHIP/Medicaid | $343.08 | ↓ -70% |
| Highmark BCBS of PA | Managed Care | $423.91 | ↓ -63% |
| Highmark BCBS of PA | Commercial - Indemnity | $435.96 | ↓ -62% |
| Aetna | Medicare | $476.50 | ↓ -58% |
| UPMC Health Plan | Commercial | $486.48 | ↓ -57% |
| Highmark BCBS of PA | UPMC Emergent | $847.81 | ↓ -26% |
| Highmark Wholecare (prev Gateway) | Medicare | $953.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $1,048.30 | ↓ -8% |
| Preferred Healthcare System | PPO | $1,238.90 | ↑ +8% |
| Coventry/First Health | Commercial | $1,334.20 | ↑ +17% |
| Fidelis | Medicare | $1,429.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $1,429.50 | ↑ +25% |
| Health Coalition Partners | Intergroup | $1,524.80 | ↑ +33% |
| Multiplan | PPO | $1,524.80 | ↑ +33% |
| Private Health Care Systems | PPO | $1,524.80 | ↑ +33% |
| SelectCare | Commercial | $1,524.80 | ↑ +33% |
| Health Payors Organization | Commercial | $1,620.10 | ↑ +42% |
| Humana | Commercial | $1,620.10 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $1,620.10 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Tc-99m mebrofenin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $282.00 | $100.11 – $423.00 |
| UPMC Passavant-McCandless | Pittsburgh | $225.60 | $94.00 – $436.63 |
| UPMC St. Margaret | Pittsburgh | $303.00 | $101.07 – $429.25 |
| UPMC Muncy | Muncy | $292.20 | $73.05 – $438.30 |
| UPMC Northwest | Seneca | $327.00 | $136.25 – $463.25 |
| UPMC Somerset | Somerset | $94.80 | $62.22 – $180.22 |
| UPMC Wellsboro | Wellsboro | $353.60 | $79.56 – $397.80 |
| UPMC Williamsport | Williamsport | $292.20 | $131.49 – $438.30 |