healthcosts.net

Vaccine tdap >=7 years im at UPMC Presbyterian

200 Lothrop Street, Pittsburgh, PA · UPMC · · NPI 119473412

Source: hospital's published price file ↗ · Published Mar 6, 2026 · Ingested Aug 13, 2026

$33.60

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.

Full explanation →

What you pay up front if you don't use insurance.

$56.00

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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$11.00 with UPMC Health Plan vs $625.86 with Highmark BCBS of PA — 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 →

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 Health Plan Managed Medicaid $11.00 ↓ -67%
United Healthcare Community Plan for Families PA CHIP/PA Medicaid $12.00 ↓ -64%
Aetna CHIP/Medicaid $13.00 ↓ -61%
Aetna Medicare $13.25 ↓ -61%
Health Partners Plans (Jefferson Health Plan) Medicaid/CHIP $15.08 ↓ -55%
Geisinger Medicaid/CHIP $15.57 ↓ -54%
AmeriHealth Caritas Community HealthChoices (CHC)/Medicaid $15.82 ↓ -53%
UPMC Work Partners Workers Comp $17.32 ↓ -48%
Multiplan Worker's Compensation $20.14 ↓ -40%
Highmark Wholecare (prev Gateway) Medicare $26.50 ↓ -21%
Preferred Healthcare System PPO $34.45 ↑ +3%
Coventry/First Health Commercial $37.10 ↑ +10%
Fidelis Medicare $39.75 ↑ +18%
InterGroup InterGroup Services Corporation $39.75 ↑ +18%
Highmark Wholecare (prev Gateway) Medicaid $39.81 ↑ +18%
PA Health & Wellness Community Health Choices/PA Medicaid HMO $39.81 ↑ +18%
Health Coalition Partners Intergroup $42.40 ↑ +26%
Multiplan PPO $42.40 ↑ +26%
Private Health Care Systems PPO $42.40 ↑ +26%
SelectCare Commercial $42.40 ↑ +26%
Health Payors Organization Commercial $45.05 ↑ +34%
Humana Commercial $45.05 ↑ +34%
InterGroup Approved National Affiliated PPO Business $45.05 ↑ +34%
UPMC Health Plan Commercial $48.97 ↑ +46%
Highmark BCBS of PA Medicare Advantage $74.61 ↑ +122%
Highmark BCBS of PA Managed Care - Social Mission $233.65 ↑ +595%
Highmark BCBS of PA Commercial - Social Mission Indemnity $240.30 ↑ +615%
Highmark BCBS of PA Managed Care $312.93 ↑ +831%
Highmark BCBS of PA Commercial - Indemnity $321.83 ↑ +858%
Highmark BCBS of PA UPMC Emergent $625.86 ↑ +1763%

Visitor-reported prices

visitor-reported
Report what you paid sign in to post

Comments

Add a comment sign in to post

Vaccine tdap >=7 years im at other Pennsylvania hospitals

Hospital City Cash price Negotiated range
UPMC Mercy Pittsburgh $42.40 $11.00 – $73.91
UPMC Passavant-McCandless Pittsburgh $31.80 $11.00 – $74.61
UPMC St. Margaret Pittsburgh $42.40 $11.00 – $74.61
UPMC Western Psychiatric Pittsburgh $31.80 $13.25 – $73.11
UPMC Muncy Muncy $42.40 $7.95 – $47.70
UPMC Northwest Seneca $42.40 $11.00 – $191.81
UPMC Somerset Somerset $54.00 $11.00 – $73.16
UPMC Wellsboro Wellsboro $42.40 $9.54 – $47.70

All Pennsylvania hospitals for this procedure →