healthcosts.net
Brca1&2 gen ful dup/del alys at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$2,287.20
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.
$3,812.00
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.
$514.12 with UPMC Health Plan vs $2,720.00 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 Health Plan | Managed Medicaid | $514.12 | ↓ -78% |
| UPMC Health Plan | Managed Medicare | $529.84 | ↓ -77% |
| United Healthcare Community Plan for Families | Unison Kids | $537.49 | ↓ -77% |
| Aetna | Medicaid | $560.86 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $577.40 | ↓ -75% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $584.23 | ↓ -74% |
| Geisinger | Medicaid/CHIP | $584.23 | ↓ -74% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $598.13 | ↓ -74% |
| Aetna | Medicare | $601.76 | ↓ -74% |
| United Healthcare | Unison Advantage Non Special Needs | $613.44 | ↓ -73% |
| Aetna of PA | Medicare | $613.44 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicare | $630.91 | ↓ -72% |
| AmeriHealth Caritas | Medicare | $630.97 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $630.97 | ↓ -72% |
| United Healthcare | Unison Advantage Special Needs | $642.65 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicaid | $693.12 | ↓ -70% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $729.63 | ↓ -68% |
| PA Health & Wellness | PA Medicaid HMO | $796.51 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $926.02 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,140.93 | ↓ -50% |
| Cigna | Commercial | $1,280.00 | ↓ -44% |
| Aetna | EBR ASO | $1,280.00 | ↓ -44% |
| Aetna | EBR FI | $1,856.00 | ↓ -19% |
| Aetna | Neighborhood Network | $1,920.00 | ↓ -16% |
| Aetna | Home Depot Employer Group | $1,974.40 | ↓ -14% |
| Aetna | NBR ASO/FI | $2,016.00 | ↓ -12% |
| Cigna | New Business ASO | $2,016.00 | ↓ -12% |
| InterGroup | PPO | $2,080.00 | ↓ -9% |
| UPMC Health Plan | Commercial | $2,209.92 | ↓ -3% |
| Coventry/First Health | Commercial | $2,240.00 | ↓ -2% |
| Health Coalition Partners | PPO | $2,304.00 | ↑ +1% |
| Private Health Care Systems | PPO | $2,560.00 | ↑ +12% |
| Humana | Commercial | $2,720.00 | ↑ +19% |
Visitor-reported prices
Comments
Brca1&2 gen ful dup/del alys at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,287.20 | $360.19 – $3,240.20 |
| UPMC Mercy | Pittsburgh | $2,287.20 | $356.80 – $3,430.80 |
| UPMC Muncy | Muncy | $2,035.20 | $508.80 – $2,713.60 |
| UPMC Presbyterian | Pittsburgh | $2,287.20 | $360.19 – $3,240.20 |
| UPMC St. Margaret | Pittsburgh | $2,287.20 | $360.19 – $3,240.20 |
| UPMC Wellsboro | Wellsboro | $3,464.00 | $467.38 – $3,897.00 |
| UPMC Williamsport | Williamsport | $2,222.40 | $514.12 – $2,963.20 |