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Diagnostic Mammogram (both breasts) at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$591.60
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.
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What you pay up front if you don't use insurance.
$986.00
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.
$142.84 with UPMC Health Plan vs $838.10 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 | $142.84 | ↓ -76% |
| United Healthcare Community Plan for Families | Unison Kids | $149.33 | ↓ -75% |
| Aetna | Medicaid | $155.82 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $191.04 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicaid | $192.57 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $202.71 | ↓ -66% |
| PA Health & Wellness | PA Medicaid HMO | $221.29 | ↓ -63% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $235.38 | ↓ -60% |
| Aetna | Medicare | $246.50 | ↓ -58% |
| Aetna | EBR ASO | $394.40 | ↓ -33% |
| Cigna | Commercial | $394.40 | ↓ -33% |
| UPMC Health Plan | Commercial | $426.05 | ↓ -28% |
| Highmark Wholecare (prev Gateway) | Medicare | $493.00 | ↓ -17% |
| Aetna | EBR FI | $571.88 | ↓ -3% |
| Aetna | Neighborhood Network | $591.60 | ↑ +0% |
| Aetna | Home Depot Employer Group | $608.36 | ↑ +3% |
| Aetna | NBR ASO/FI | $621.18 | ↑ +5% |
| Cigna | New Business ASO | $621.18 | ↑ +5% |
| InterGroup | PPO | $640.90 | ↑ +8% |
| Coventry/First Health | Commercial | $690.20 | ↑ +17% |
| Health Coalition Partners | PPO | $709.92 | ↑ +20% |
| Private Health Care Systems | PPO | $788.80 | ↑ +33% |
| Humana | Commercial | $838.10 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Diagnostic Mammogram (both breasts) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $612.00 | $73.61 – $714.00 |
| UPMC Carlisle | Carlisle | $310.20 | $70.83 – $611.06 |
| UPMC Altoona | Altoona | $583.20 | $73.61 – $777.60 |
| UPMC Bedford | Everett | $609.00 | $136.34 – $913.50 |
| UPMC Cole | Coudersport | $458.40 | $136.34 – $611.20 |
| UPMC Community Osteopathic | Harrisburg | $310.20 | $103.40 – $675.02 |
| UPMC Hanover | Hanover | $310.20 | $98.23 – $611.06 |
| UPMC Jameson | New Castle | $306.00 | $74.91 – $448.80 |