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Tc-99m mertiatide at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2,142.00
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.
$3,570.00
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.
$642.60 with Aetna vs $7,012.77 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $642.60 | ↓ -70% |
| Highmark BCBS of PA | Medicare Advantage | $836.00 | ↓ -61% |
| Aetna | Medicare | $892.50 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,785.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $1,963.50 | ↓ -8% |
| Preferred Healthcare System | PPO | $2,320.50 | ↑ +8% |
| UPMC Health Plan | Commercial | $2,344.31 | ↑ +9% |
| Coventry/First Health | Commercial | $2,499.00 | ↑ +17% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,618.08 | ↑ +22% |
| Fidelis | Medicare | $2,677.50 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $2,677.50 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,692.53 | ↑ +26% |
| Health Coalition Partners | Intergroup | $2,856.00 | ↑ +33% |
| Multiplan | PPO | $2,856.00 | ↑ +33% |
| Private Health Care Systems | PPO | $2,856.00 | ↑ +33% |
| SelectCare | Commercial | $2,856.00 | ↑ +33% |
| Health Payors Organization | Commercial | $3,034.50 | ↑ +42% |
| Humana | Commercial | $3,034.50 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $3,034.50 | ↑ +42% |
| Highmark BCBS of PA | Managed Care | $3,506.39 | ↑ +64% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,606.09 | ↑ +68% |
| Highmark BCBS of PA | UPMC Emergent | $7,012.77 | ↑ +227% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Multiplan | Worker's Compensation | not published by hospital | — |
Visitor-reported prices
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Tc-99m mertiatide at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $2,074.20 | $828.11 – $3,111.30 |
| UPMC Passavant-McCandless | Pittsburgh | $1,978.20 | $824.25 – $2,802.45 |
| UPMC St. Margaret | Pittsburgh | $1,909.80 | $795.75 – $2,705.55 |
| UPMC Muncy | Muncy | $709.20 | $177.30 – $1,063.80 |
| UPMC Somerset | Somerset | $1,284.60 | $819.74 – $1,605.75 |
| UPMC Wellsboro | Wellsboro | $857.60 | $192.96 – $964.80 |
| UPMC Williamsport | Williamsport | $709.20 | $319.14 – $1,063.80 |