healthcosts.net
Pembrolizumab 25 mg/ml intravenous solution at UPMC Western Psychiatric
3811 Ohara St, Pittsburgh, PA · UPMC · · NPI 1174962435
$154.80
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.
$258.00
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.
$30.60 with Highmark BCBS of PA vs $219.30 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 | $30.60 | ↓ -80% |
| Geisinger | CHIP | $60.29 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $65.11 | ↓ -58% |
| Aetna | Medicare | $66.32 | ↓ -57% |
| Aetna | Narrow Network | $76.63 | ↓ -50% |
| Aetna | Fully Insured | $85.14 | ↓ -45% |
| Aetna | Commercial | $90.30 | ↓ -42% |
| Cigna Behavioral Health | Commercial | $154.80 | ↑ +0% |
| Fidelis | Medicare | $193.50 | ↑ +25% |
| Health Payors Organization | Commercial | $219.30 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Pembrolizumab 25 mg/ml intravenous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $199.20 | $30.93 – $224.10 |
| UPMC Passavant-McCandless | Pittsburgh | $7,026.00 | $31.22 – $140.25 |
| UPMC St. Margaret | Pittsburgh | not published | $31.22 – $11,809.63 |
| UPMC Northwest | Seneca | $199.20 | $38.07 – $211.65 |
| UPMC Somerset | Somerset | $850.20 | $30.62 – $1,062.75 |
| UPMC Williamsport | Williamsport | $287.20 | $60.29 – $323.10 |
| UPMC Muncy | Muncy | $21,534.00 | $53.85 – $323.10 |
| UPMC Wellsboro | Wellsboro | $21,534.00 | $60.29 – $323.10 |