healthcosts.net
Tissue culture skin/biopsy at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$1,768.80
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.
?
What you pay up front if you don't use insurance.
$2,948.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$139.08 with UPMC Work Partners vs $2,505.80 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $139.08 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $151.99 | ↓ -91% |
| United Healthcare | Medicare | $151.99 | ↓ -91% |
| Cigna Lifesource | Medicare Transplant | $151.99 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $151.99 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $151.99 | ↓ -91% |
| Aetna | Medicare | $154.80 | ↓ -91% |
| Aetna of PA | Medicare | $154.80 | ↓ -91% |
| Multiplan | Worker's Compensation | $161.72 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $189.00 | ↓ -89% |
| UPMC Health Plan | Managed Medicaid | $207.90 | ↓ -88% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $226.80 | ↓ -87% |
| Aetna | CHIP/Medicaid | $245.70 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $280.29 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $294.22 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $299.07 | ↓ -83% |
| UPMC Health Plan | Commercial | $318.24 | ↓ -82% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $322.09 | ↓ -82% |
| Highmark BCBS of PA | Medicare Advantage | $386.16 | ↓ -78% |
| Highmark BCBS of PA | Managed Care - Social Mission | $641.88 | ↓ -64% |
| Highmark BCBS of PA | Managed Care | $859.56 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,014.54 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,358.71 | ↓ -23% |
| Highmark BCBS of PA | UPMC Emergent | $1,719.13 | ↓ -3% |
| Preferred Healthcare System | PPO | $1,916.20 | ↑ +8% |
| Coventry/First Health | Commercial | $2,063.60 | ↑ +17% |
| Fidelis | Medicare | $2,211.00 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $2,211.00 | ↑ +25% |
| Health Coalition Partners | Intergroup | $2,358.40 | ↑ +33% |
| Private Health Care Systems | PPO | $2,358.40 | ↑ +33% |
| SelectCare | Commercial | $2,358.40 | ↑ +33% |
| Multiplan | PPO | $2,358.40 | ↑ +33% |
| InterGroup | Approved National Affiliated PPO Business | $2,505.80 | ↑ +42% |
| Health Payors Organization | Commercial | $2,505.80 | ↑ +42% |
| Humana | Commercial | $2,505.80 | ↑ +42% |
Visitor-reported prices
Comments
Tissue culture skin/biopsy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,441.80 | $117.31 – $2,162.70 |
| UPMC Passavant-McCandless | Pittsburgh | $1,575.60 | $130.78 – $2,232.10 |
| UPMC St. Margaret | Pittsburgh | $1,476.00 | $121.51 – $2,091.00 |
| UPMC Muncy | Muncy | $1,299.00 | $139.08 – $1,732.00 |
| UPMC Northwest | Seneca | $1,296.60 | $127.63 – $1,836.85 |
| UPMC Somerset | Somerset | $1,007.40 | $139.08 – $1,259.25 |
| UPMC Wellsboro | Wellsboro | $1,571.20 | $139.08 – $1,767.60 |
| UPMC Williamsport | Williamsport | $1,299.00 | $139.08 – $1,732.00 |