Composite drsg >16<=48 sq in at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$42.60
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.
$71.00
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.
$12.75 with Aetna vs $43.35 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 |
|---|---|---|---|
| Aetna | Medicare | $12.75 | ↓ -70% |
| UPMC Work Partners | Workers Comp | $14.32 | ↓ -66% |
| Cigna | Commercial | $20.40 | ↓ -52% |
| Aetna | EBR ASO | $20.40 | ↓ -52% |
| Highmark Wholecare (prev Gateway) | Medicare | $25.50 | ↓ -40% |
| PA Health & Wellness | PA Medicaid HMO | $28.05 | ↓ -34% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $28.66 | ↓ -33% |
| Aetna | EBR FI | $29.58 | ↓ -31% |
| Aetna | Neighborhood Network | $30.60 | ↓ -28% |
| Aetna | Home Depot Employer Group | $31.47 | ↓ -26% |
| Cigna | New Business ASO | $32.13 | ↓ -25% |
| Aetna | NBR ASO/FI | $32.13 | ↓ -25% |
| InterGroup | PPO | $33.15 | ↓ -22% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $35.31 | ↓ -17% |
| Coventry/First Health | Commercial | $35.70 | ↓ -16% |
| Health Coalition Partners | PPO | $36.72 | ↓ -14% |
| Private Health Care Systems | PPO | $40.80 | ↓ -4% |
| UPMC Health Plan | Commercial | $42.15 | ↓ -1% |
| Humana | Commercial | $43.35 | ↑ +2% |
Visitor-reported prices
Comments
Composite drsg >16<=48 sq in at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $4.20 | $1.75 – $34.83 |
| UPMC Magee | Pittsburgh | $4.80 | $5.86 – $34.83 |
| UPMC Mercy | Pittsburgh | $3.60 | $11.04 – $27.50 |
| UPMC Passavant-McCandless | Pittsburgh | $4.80 | $11.15 – $50.55 |
| UPMC Presbyterian | Pittsburgh | $6.00 | $6.73 – $56.32 |
| UPMC St. Margaret | Pittsburgh | $43.20 | $11.15 – $42.74 |
| UPMC Wellsboro | Wellsboro | $5.40 | $7.18 – $14.32 |