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Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$4,393.20
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.
$7,322.00
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.
$52.82 with UPMC Health Plan vs $6,223.70 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 | $52.82 | ↓ -99% |
| United Healthcare Community Plan for Families | Unison Kids | $55.22 | ↓ -99% |
| Aetna | Medicaid | $57.62 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $71.21 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $74.96 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $81.84 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $257.11 | ↓ -94% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,611.51 | ↓ -63% |
| Aetna | Medicare | $1,830.50 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,985.50 | ↓ -55% |
| UPMC Health Plan | Commercial | $2,357.21 | ↓ -46% |
| Aetna | EBR ASO | $2,928.80 | ↓ -33% |
| Cigna | Commercial | $2,928.80 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,661.00 | ↓ -17% |
| InterGroup | PPO | $3,704.00 | ↓ -16% |
| Aetna | EBR FI | $4,246.76 | ↓ -3% |
| Aetna | Neighborhood Network | $4,393.20 | ↑ +0% |
| Aetna | Home Depot Employer Group | $4,517.67 | ↑ +3% |
| Aetna | NBR ASO/FI | $4,612.86 | ↑ +5% |
| Cigna | New Business ASO | $4,612.86 | ↑ +5% |
| Coventry/First Health | Commercial | $5,125.40 | ↑ +17% |
| Health Coalition Partners | PPO | $5,271.84 | ↑ +20% |
| Private Health Care Systems | PPO | $5,857.60 | ↑ +33% |
| Humana | Commercial | $6,223.70 | ↑ +42% |
Visitor-reported prices
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Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,192.80 | $52.82 – $5,939.80 |
| UPMC Mercy | Pittsburgh | $7,348.20 | $52.82 – $11,022.30 |
| UPMC Presbyterian | Pittsburgh | $4,494.60 | $52.82 – $6,367.35 |
| UPMC Somerset | Somerset | $2,224.80 | $52.82 – $2,781.00 |
| UPMC St. Margaret | Pittsburgh | $2,148.00 | $52.82 – $3,043.00 |
| UPMC Williamsport | Williamsport | $3,434.40 | $52.82 – $4,579.20 |