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Cdna analysis for variants at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$7,041.00
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.
$11,735.00
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.
$167.96 with UPMC Health Plan vs $1,466.24 with Highmark BCBS of PA — 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 Medicare | $167.96 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $183.04 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $185.20 | ↓ -97% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $185.20 | ↓ -97% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $189.61 | ↓ -97% |
| Aetna | Medicare | $190.76 | ↓ -97% |
| Aetna of PA | Medicare | $194.46 | ↓ -97% |
| United Healthcare | Unison Advantage Non Special Needs | $194.46 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicare | $200.00 | ↓ -97% |
| AmeriHealth Caritas | Medicare | $200.02 | ↓ -97% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $200.02 | ↓ -97% |
| United Healthcare | Unison Advantage Special Needs | $203.72 | ↓ -97% |
| Aetna | EBR ASO | $228.80 | ↓ -97% |
| Cigna | Commercial | $228.80 | ↓ -97% |
| UPMC Health Plan | Commercial | $271.55 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $314.60 | ↓ -96% |
| Aetna | EBR FI | $331.76 | ↓ -95% |
| Aetna | Neighborhood Network | $343.20 | ↓ -95% |
| Aetna | Home Depot Employer Group | $352.92 | ↓ -95% |
| Aetna | NBR ASO/FI | $360.36 | ↓ -95% |
| Cigna | New Business ASO | $360.36 | ↓ -95% |
| InterGroup | PPO | $371.80 | ↓ -95% |
| Coventry/First Health | Commercial | $400.40 | ↓ -94% |
| Health Coalition Partners | PPO | $411.84 | ↓ -94% |
| Private Health Care Systems | PPO | $457.60 | ↓ -94% |
| Humana | Commercial | $486.20 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,190.06 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,466.24 | ↓ -79% |
Visitor-reported prices
Comments
Cdna analysis for variants at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,118.00 | $141.78 – $462.90 |
| UPMC Mercy | Pittsburgh | $2,009.40 | $154.38 – $916.20 |
| UPMC Muncy | Muncy | $1,792.80 | $144.60 – $948.00 |
| UPMC Presbyterian | Pittsburgh | $2,009.40 | $70.74 – $462.90 |
| UPMC Somerset | Somerset | $1,070.40 | $129.92 – $1,338.00 |
| UPMC St. Margaret | Pittsburgh | $2,008.20 | $159.90 – $850.00 |
| UPMC Wellsboro | Wellsboro | $2,276.80 | $96.12 – $480.60 |
| UPMC Williamsport | Williamsport | $1,934.40 | $144.60 – $633.60 |