healthcosts.net
Clsd tx hip disloc without anes 27265 at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$1,632.60
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.
?
What you pay up front if you don't use insurance.
$2,721.00
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.
$207.41 with UPMC Health Plan vs $2,312.85 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 | $207.41 | ↓ -87% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $228.70 | ↓ -86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $234.14 | ↓ -86% |
| Aetna | Medicare | $235.56 | ↓ -86% |
| United Healthcare | Unison Advantage Non Special Needs | $240.13 | ↓ -85% |
| Aetna of PA | Medicare | $240.13 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $246.97 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $247.00 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.00 | ↓ -85% |
| United Healthcare | Unison Advantage Special Needs | $251.57 | ↓ -85% |
| UPMC Health Plan | Managed Medicaid | $260.70 | ↓ -84% |
| United Healthcare Community Plan for Families | Unison Kids | $272.55 | ↓ -83% |
| Aetna | Medicaid | $284.40 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $351.47 | ↓ -78% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $369.98 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $403.90 | ↓ -75% |
| UPMC Health Plan | Commercial | $817.61 | ↓ -50% |
| UPMC Work Partners | Workers Comp | $877.01 | ↓ -46% |
| Cigna | Commercial | $1,088.40 | ↓ -33% |
| Aetna | EBR ASO | $1,088.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,414.58 | ↓ -13% |
| Aetna | EBR FI | $1,578.18 | ↓ -3% |
| Aetna | Neighborhood Network | $1,632.60 | ↑ +0% |
| Aetna | Home Depot Employer Group | $1,678.86 | ↑ +3% |
| Aetna | NBR ASO/FI | $1,714.23 | ↑ +5% |
| Cigna | New Business ASO | $1,714.23 | ↑ +5% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,742.87 | ↑ +7% |
| InterGroup | PPO | $1,768.65 | ↑ +8% |
| Coventry/First Health | Commercial | $1,904.70 | ↑ +17% |
| Health Coalition Partners | PPO | $1,959.12 | ↑ +20% |
| Private Health Care Systems | PPO | $2,176.80 | ↑ +33% |
| Humana | Commercial | $2,312.85 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx hip disloc without anes 27265 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,547.40 | $212.53 – $2,192.15 |
| UPMC Mercy | Pittsburgh | $1,434.00 | $190.64 – $2,151.00 |
| UPMC Muncy | Muncy | $718.20 | $179.55 – $1,107.39 |
| UPMC Presbyterian | Pittsburgh | $3,772.80 | $247.00 – $5,344.80 |
| UPMC Somerset | Somerset | $1,272.60 | $226.41 – $1,590.75 |
| UPMC St. Margaret | Pittsburgh | $2,070.60 | $197.46 – $2,933.35 |
| UPMC Wellsboro | Wellsboro | $868.80 | $195.48 – $1,080.46 |
| UPMC Williamsport | Williamsport | $718.20 | $230.94 – $1,107.39 |