healthcosts.net
Inj mogamulizumab-kpkc, 1 mg at UPMC Western Psychiatric
3811 Ohara St, Pittsburgh, PA · UPMC · · NPI 1174962435
$691.20
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.
$1,152.00
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.
$119.63 with Highmark BCBS of PA vs $979.20 with Health Payors Organization — 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 | Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $119.63 | ↓ -83% |
| Geisinger | CHIP | $248.50 | ↓ -64% |
| Highmark Wholecare (prev Gateway) | Medicare | $268.38 | ↓ -61% |
| Aetna | Medicare | $273.35 | ↓ -60% |
| Aetna | Narrow Network | $342.14 | ↓ -51% |
| Aetna | Fully Insured | $380.16 | ↓ -45% |
| Aetna | Commercial | $403.20 | ↓ -42% |
| Cigna Behavioral Health | Commercial | $691.20 | ↑ +0% |
| Fidelis | Medicare | $864.00 | ↑ +25% |
| Health Payors Organization | Commercial | $979.20 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Inj mogamulizumab-kpkc, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $691.20 | $120.93 – $777.60 |
| UPMC Passavant-McCandless | Pittsburgh | $691.20 | $122.09 – $724.20 |
| UPMC St. Margaret | Pittsburgh | $691.20 | $122.09 – $734.40 |
| UPMC Muncy | Muncy | $558.40 | $104.70 – $628.20 |
| UPMC Northwest | Seneca | $691.20 | $156.90 – $734.40 |
| UPMC Somerset | Somerset | $540.60 | $119.71 – $675.75 |
| UPMC Wellsboro | Wellsboro | $558.40 | $125.64 – $628.20 |
| UPMC Williamsport | Williamsport | $558.40 | $189.30 – $628.20 |