healthcosts.net
Bln 1.2 mono emrg 15x1.2 at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$3,042.60
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.
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What you pay up front if you don't use insurance.
$5,071.00
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.
$66.00 with Aetna vs $1,542.13 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | Medicare | $66.00 | ↓ -98% |
| Aetna | EBR ASO | $105.60 | ↓ -97% |
| Cigna | Commercial | $105.60 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicare | $132.00 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $145.20 | ↓ -95% |
| Aetna | EBR FI | $153.12 | ↓ -95% |
| Aetna | Neighborhood Network | $158.40 | ↓ -95% |
| Aetna | Home Depot Employer Group | $162.89 | ↓ -95% |
| Aetna | NBR ASO/FI | $166.32 | ↓ -95% |
| Cigna | New Business ASO | $166.32 | ↓ -95% |
| InterGroup | PPO | $171.60 | ↓ -94% |
| Coventry/First Health | Commercial | $184.80 | ↓ -94% |
| Health Coalition Partners | PPO | $190.08 | ↓ -94% |
| Private Health Care Systems | PPO | $211.20 | ↓ -93% |
| Humana | Commercial | $224.40 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $291.28 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $344.40 | ↓ -89% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $883.43 | ↓ -71% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,088.45 | ↓ -64% |
| UPMC Health Plan | Commercial | $1,542.13 | ↓ -49% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Bln 1.2 mono emrg 15x1.2 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $8,967.60 | $41.75 – $1,006.31 |
| UPMC Muncy | Muncy | $805.80 | $63.90 – $383.40 |
| UPMC Passavant-McCandless | Pittsburgh | $9,111.60 | $51.75 – $1,849.30 |
| UPMC Presbyterian | Pittsburgh | $15,157.20 | $9.18 – $2,060.46 |
| UPMC Somerset | Somerset | $6,126.60 | $110.66 – $763.32 |
| UPMC St. Margaret | Pittsburgh | $6,582.60 | $102.00 – $1,563.77 |
| UPMC Wellsboro | Wellsboro | $5,457.60 | $69.66 – $348.30 |
| UPMC Williamsport | Williamsport | $3,807.00 | $75.87 – $252.90 |