healthcosts.net
Transcatheter bx s&i at UPMC Presbyterian
200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412
$2,866.20
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.
$4,777.00
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.
$12.00 with United Healthcare Community Plan for Families vs $4,060.45 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $12.00 | ↓ -100% |
| UPMC Health Plan | Managed Medicaid | $19.25 | ↓ -99% |
| Aetna | CHIP/Medicaid | $22.75 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $25.95 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $26.39 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $27.24 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $27.69 | ↓ -99% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $29.82 | ↓ -99% |
| Highmark BCBS of PA | Medicare Advantage | $546.51 | ↓ -81% |
| UPMC Health Plan | Commercial | $1,080.56 | ↓ -62% |
| Aetna | Medicare | $1,194.25 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $1,195.62 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,354.73 | ↓ -53% |
| Multiplan | Worker's Compensation | $1,390.25 | ↓ -51% |
| Highmark BCBS of PA | Managed Care | $1,814.16 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,388.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,555.22 | ↓ -11% |
| Preferred Healthcare System | PPO | $3,105.05 | ↑ +8% |
| Coventry/First Health | Commercial | $3,343.90 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,422.07 | ↑ +19% |
| Fidelis | Medicare | $3,582.75 | ↑ +25% |
| InterGroup | InterGroup Services Corporation | $3,582.75 | ↑ +25% |
| Highmark BCBS of PA | UPMC Emergent | $3,628.33 | ↑ +27% |
| Health Coalition Partners | Intergroup | $3,821.60 | ↑ +33% |
| Multiplan | PPO | $3,821.60 | ↑ +33% |
| Private Health Care Systems | PPO | $3,821.60 | ↑ +33% |
| SelectCare | Commercial | $3,821.60 | ↑ +33% |
| Health Payors Organization | Commercial | $4,060.45 | ↑ +42% |
| Humana | Commercial | $4,060.45 | ↑ +42% |
| InterGroup | Approved National Affiliated PPO Business | $4,060.45 | ↑ +42% |
Visitor-reported prices
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Transcatheter bx s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,277.20 | $19.25 – $4,642.70 |
| UPMC Mercy | Pittsburgh | $2,360.40 | $19.25 – $3,540.60 |
| UPMC St. Margaret | Pittsburgh | $2,236.20 | $19.25 – $3,167.95 |
| UPMC Somerset | Somerset | $6,169.80 | $11.50 – $7,712.25 |
| UPMC Williamsport | Williamsport | $2,803.80 | $12.80 – $3,738.40 |