healthcosts.net
Clozapine, 25 mg at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$17.40
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.
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What you pay up front if you don't use insurance.
$21.75
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.
$0.28 with United Healthcare Community Plan for Families vs $7.43 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | Unison MedPLUS | $0.28 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison Kids | $0.31 | ↓ -98% |
| Aetna | Medicaid | $0.32 | ↓ -98% |
| Aetna | Medicare | $1.69 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $2.44 | ↓ -86% |
| Aetna | EBR ASO | $2.70 | ↓ -84% |
| Cigna | Commercial | $2.70 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $3.38 | ↓ -81% |
| PA Health & Wellness | PA Medicaid HMO | $3.71 | ↓ -79% |
| Aetna | EBR FI | $3.92 | ↓ -77% |
| Aetna | Neighborhood Network | $4.05 | ↓ -77% |
| Aetna | Home Depot Employer Group | $4.16 | ↓ -76% |
| Aetna | NBR ASO/FI | $4.25 | ↓ -76% |
| Cigna | New Business ASO | $4.25 | ↓ -76% |
| InterGroup | PPO | $4.39 | ↓ -75% |
| Coventry/First Health | Commercial | $4.72 | ↓ -73% |
| Health Coalition Partners | PPO | $4.86 | ↓ -72% |
| Private Health Care Systems | PPO | $5.40 | ↓ -69% |
| Humana | Commercial | $5.74 | ↓ -67% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $6.03 | ↓ -65% |
| UPMC Health Plan | Commercial | $6.71 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $7.43 | ↓ -57% |
Visitor-reported prices
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Clozapine, 25 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $5.40 | $0.31 – $4.38 |
| UPMC Muncy | Muncy | $8.40 | $0.98 – $5.85 |
| UPMC Passavant-McCandless | Pittsburgh | $18.60 | $0.28 – $8.05 |
| UPMC Presbyterian | Pittsburgh | $18.60 | $0.27 – $8.96 |
| UPMC St. Margaret | Pittsburgh | $7.60 | $0.29 – $6.80 |
| UPMC Wellsboro | Wellsboro | $8.40 | $0.27 – $5.85 |
| UPMC Western Psychiatric | Pittsburgh | $18.60 | $2.19 – $7.44 |
| UPMC Williamsport | Williamsport | $8.40 | $1.75 – $5.85 |