healthcosts.net
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$1,176.60
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.
$1,961.00
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.
$69.65 with UPMC Health Plan vs $3,001.48 with United Healthcare — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $69.65 | ↓ -94% |
| United Healthcare Community Plan for Families | Unison Kids | $72.82 | ↓ -94% |
| Aetna | Medicaid | $75.98 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $93.90 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $98.85 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $107.91 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $213.06 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $273.63 | ↓ -77% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $337.14 | ↓ -71% |
| Cigna | Commercial | $784.40 | ↓ -33% |
| Aetna | EBR ASO | $784.40 | ↓ -33% |
| Aetna | EBR FI | $1,137.38 | ↓ -3% |
| Aetna | Neighborhood Network | $1,176.60 | ↑ +0% |
| Aetna | Home Depot Employer Group | $1,209.94 | ↑ +3% |
| Aetna | NBR ASO/FI | $1,235.43 | ↑ +5% |
| Cigna | New Business ASO | $1,235.43 | ↑ +5% |
| InterGroup | PPO | $1,274.65 | ↑ +8% |
| Coventry/First Health | Commercial | $1,372.70 | ↑ +17% |
| Health Coalition Partners | PPO | $1,411.92 | ↑ +20% |
| UPMC Health Plan | Commercial | $1,535.30 | ↑ +30% |
| Private Health Care Systems | PPO | $1,568.80 | ↑ +33% |
| Humana | Commercial | $1,666.85 | ↑ +42% |
| UPMC Health Plan | Managed Medicare | $2,474.59 | ↑ +110% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,728.62 | ↑ +132% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $2,793.56 | ↑ +137% |
| Aetna | Medicare | $2,810.48 | ↑ +139% |
| United Healthcare | Unison Advantage Non Special Needs | $2,865.05 | ↑ +144% |
| Aetna of PA | Medicare | $2,865.05 | ↑ +144% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,946.64 | ↑ +150% |
| AmeriHealth Caritas | Medicare | $2,946.91 | ↑ +150% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,946.91 | ↑ +150% |
| United Healthcare | Unison Advantage Special Needs | $3,001.48 | ↑ +155% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy(ies) & aspiration(s) bone marrow diagnostic (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,745.40 | $69.65 – $3,001.48 |
| UPMC Mercy | Pittsburgh | $1,745.40 | $69.65 – $2,865.05 |
| UPMC Muncy | Muncy | $1,712.40 | $69.65 – $2,283.20 |
| UPMC Presbyterian | Pittsburgh | $1,745.40 | $69.65 – $3,001.48 |
| UPMC Somerset | Somerset | $4,644.60 | $69.65 – $5,805.75 |
| UPMC Wellsboro | Wellsboro | $3,164.80 | $69.65 – $993.28 |
| UPMC Williamsport | Williamsport | $1,712.40 | $69.65 – $2,283.20 |