healthcosts.net
Blood Culture Test at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$137.40
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.
?
What you pay up front if you don't use insurance.
$229.00
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.
$9.36 with UPMC Health Plan vs $194.65 with Humana — 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 Medicare | $9.36 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $10.20 | ↓ -93% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $10.32 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $10.32 | ↓ -92% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10.57 | ↓ -92% |
| Aetna | Medicare | $10.63 | ↓ -92% |
| United Healthcare | Unison Advantage Non Special Needs | $10.84 | ↓ -92% |
| Aetna of PA | Medicare | $10.84 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $11.14 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $11.15 | ↓ -92% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11.15 | ↓ -92% |
| United Healthcare | Unison Advantage Special Needs | $11.35 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $15.40 | ↓ -89% |
| United Healthcare Community Plan for Families | Unison Kids | $16.10 | ↓ -88% |
| Aetna | Medicaid | $16.80 | ↓ -88% |
| UPMC Health Plan | Commercial | $17.83 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $20.76 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $21.86 | ↓ -84% |
| PA Health & Wellness | PA Medicaid HMO | $23.86 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $51.81 | ↓ -62% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $63.84 | ↓ -54% |
| Cigna | Commercial | $91.60 | ↓ -33% |
| Aetna | EBR ASO | $91.60 | ↓ -33% |
| Aetna | EBR FI | $132.82 | ↓ -3% |
| Aetna | Neighborhood Network | $137.40 | ↑ +0% |
| Aetna | Home Depot Employer Group | $141.29 | ↑ +3% |
| Aetna | NBR ASO/FI | $144.27 | ↑ +5% |
| Cigna | New Business ASO | $144.27 | ↑ +5% |
| InterGroup | PPO | $148.85 | ↑ +8% |
| Coventry/First Health | Commercial | $160.30 | ↑ +17% |
| Health Coalition Partners | PPO | $164.88 | ↑ +20% |
| Private Health Care Systems | PPO | $183.20 | ↑ +33% |
| Humana | Commercial | $194.65 | ↑ +42% |
Visitor-reported prices
Comments
Blood Culture Test at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $155.40 | $10.20 – $207.20 |
| UPMC Passavant-McCandless | Pittsburgh | $322.20 | $9.59 – $456.45 |
| UPMC Hamot | Erie | $240.00 | $10.20 – $280.00 |
| UPMC Carlisle | Carlisle | $57.00 | $9.89 – $80.75 |
| UPMC Altoona | Altoona | $115.80 | $10.20 – $154.40 |
| UPMC Bedford | Everett | $75.00 | $3.72 – $112.50 |
| UPMC Cole | Coudersport | $73.80 | $6.71 – $98.40 |
| UPMC Community Osteopathic | Harrisburg | $57.00 | $10.22 – $80.75 |