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New Patient Office Visit (level 2) at UPMC Western Psychiatric
3811 Ohara St, Pittsburgh, PA · UPMC · · NPI 1174962435
$200.40
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.
$334.00
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.
$73.52 with Highmark BCBS of PA vs $252.45 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 | $73.52 | ↓ -63% |
| Aetna | Medicare | $74.25 | ↓ -63% |
| Aetna | Narrow Network | $88.21 | ↓ -56% |
| Aetna | Fully Insured | $98.01 | ↓ -51% |
| Aetna | Commercial | $103.95 | ↓ -48% |
| Highmark Wholecare (prev Gateway) | Medicare | $148.50 | ↓ -26% |
| Cigna Behavioral Health | Commercial | $178.20 | ↓ -11% |
| Fidelis | Medicare | $222.75 | ↑ +11% |
| Health Payors Organization | Commercial | $252.45 | ↑ +26% |
Visitor-reported prices
Comments
New Patient Office Visit (level 2) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $183.60 | $38.86 – $260.10 |
| UPMC Magee | Pittsburgh | $253.80 | $38.86 – $389.16 |
| UPMC Mercy | Pittsburgh | $149.40 | $36.08 – $224.10 |
| UPMC Presbyterian | Pittsburgh | $200.40 | $38.86 – $283.90 |
| UPMC St. Margaret | Pittsburgh | $142.20 | $38.86 – $201.45 |
| UPMC East | Monroeville | $255.60 | $36.08 – $340.80 |
| UPMC Hamot | Erie | $180.00 | $38.86 – $210.00 |
| UPMC Altoona | Altoona | $207.00 | $20.00 – $276.00 |