healthcosts.net
Injection, fulvestrant at UPMC Western Psychiatric
3811 Ohara St, Pittsburgh, PA · UPMC · · NPI 1174962435
$921.60
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.
?
What you pay up front if you don't use insurance.
$1,536.00
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.
$6.73 with Geisinger vs $1,305.60 with Health Payors Organization — 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 |
|---|---|---|---|
| Geisinger | CHIP | $6.73 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $7.27 | ↓ -99% |
| Aetna | Medicare | $7.40 | ↓ -99% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $164.96 | ↓ -82% |
| Aetna | Narrow Network | $456.19 | ↓ -51% |
| Aetna | Fully Insured | $506.88 | ↓ -45% |
| Aetna | Commercial | $537.60 | ↓ -42% |
| Cigna Behavioral Health | Commercial | $921.60 | ↑ +0% |
| Fidelis | Medicare | $1,152.00 | ↑ +25% |
| Health Payors Organization | Commercial | $1,305.60 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Injection, fulvestrant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,940.80 | $4.25 – $166.75 |
| UPMC Passavant-McCandless | Pittsburgh | $4,829.40 | $4.25 – $250.75 |
| UPMC Presbyterian | Pittsburgh | $9,219.60 | $4.25 – $1,305.60 |
| UPMC St. Margaret | Pittsburgh | $912.80 | $4.25 – $168.34 |
| UPMC Muncy | Muncy | $4,423.20 | $6.73 – $663.30 |
| UPMC Northwest | Seneca | $6,048.60 | $4.25 – $127.10 |
| UPMC Wellsboro | Wellsboro | $4,423.20 | $6.73 – $663.30 |
| UPMC Williamsport | Williamsport | $589.60 | $6.73 – $663.30 |