healthcosts.net
Balloon dilate urtrl strix at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$10,138.20
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.
$16,897.00
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.
$981.76 with UPMC Work Partners vs $14,362.45 with Humana — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $981.76 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,330.35 | ↓ -87% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,639.09 | ↓ -84% |
| UPMC Health Plan | Commercial | $2,411.88 | ↓ -76% |
| InterGroup | PPO | $3,704.00 | ↓ -63% |
| Aetna | Medicare | $4,224.25 | ↓ -58% |
| Aetna | EBR ASO | $6,758.80 | ↓ -33% |
| Cigna | Commercial | $6,758.80 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $8,448.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $9,293.35 | ↓ -8% |
| Aetna | EBR FI | $9,800.26 | ↓ -3% |
| Aetna | Neighborhood Network | $10,138.20 | ↑ +0% |
| Aetna | Home Depot Employer Group | $10,425.45 | ↑ +3% |
| Aetna | NBR ASO/FI | $10,645.11 | ↑ +5% |
| Cigna | New Business ASO | $10,645.11 | ↑ +5% |
| Coventry/First Health | Commercial | $11,827.90 | ↑ +17% |
| Health Coalition Partners | PPO | $12,165.84 | ↑ +20% |
| Private Health Care Systems | PPO | $13,517.60 | ↑ +33% |
| Humana | Commercial | $14,362.45 | ↑ +42% |
Visitor-reported prices
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Balloon dilate urtrl strix at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $8,620.20 | $517.46 – $12,211.95 |
| UPMC Mercy | Pittsburgh | $6,571.80 | $512.58 – $9,857.70 |
| UPMC Presbyterian | Pittsburgh | $10,911.00 | $183.38 – $15,457.25 |
| UPMC Somerset | Somerset | $3,457.20 | $175.74 – $4,321.50 |
| UPMC St. Margaret | Pittsburgh | $8,132.40 | $517.46 – $11,520.90 |