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Diagnostic Mammogram (one breast) at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$487.20
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.
$812.00
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.
$112.65 with UPMC Health Plan vs $690.20 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 | $112.65 | ↓ -77% |
| United Healthcare Community Plan for Families | Unison Kids | $117.77 | ↓ -76% |
| Aetna | Medicaid | $122.89 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $149.79 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicaid | $151.87 | ↓ -69% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $159.87 | ↓ -67% |
| PA Health & Wellness | PA Medicaid HMO | $174.53 | ↓ -64% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $184.56 | ↓ -62% |
| Aetna | Medicare | $203.00 | ↓ -58% |
| UPMC Health Plan | Commercial | $229.99 | ↓ -53% |
| Aetna | EBR ASO | $324.80 | ↓ -33% |
| Cigna | Commercial | $324.80 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $406.00 | ↓ -17% |
| Aetna | EBR FI | $470.96 | ↓ -3% |
| Aetna | Neighborhood Network | $487.20 | ↑ +0% |
| Aetna | Home Depot Employer Group | $501.00 | ↑ +3% |
| Aetna | NBR ASO/FI | $511.56 | ↑ +5% |
| Cigna | New Business ASO | $511.56 | ↑ +5% |
| InterGroup | PPO | $527.80 | ↑ +8% |
| Coventry/First Health | Commercial | $568.40 | ↑ +17% |
| Health Coalition Partners | PPO | $584.64 | ↑ +20% |
| Private Health Care Systems | PPO | $649.60 | ↑ +33% |
| Humana | Commercial | $690.20 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Diagnostic Mammogram (one breast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $336.60 | $58.27 – $448.80 |
| UPMC Passavant-McCandless | Pittsburgh | $427.20 | $58.27 – $605.20 |
| UPMC Hamot | Erie | $478.80 | $57.72 – $558.60 |
| UPMC Carlisle | Carlisle | $243.60 | $19.45 – $479.38 |
| UPMC Altoona | Altoona | $475.80 | $57.72 – $634.40 |
| UPMC Bedford | Everett | $502.20 | $107.53 – $753.30 |
| UPMC Cole | Coudersport | $360.00 | $107.53 – $480.00 |
| UPMC Community Osteopathic | Harrisburg | $349.80 | $28.40 – $364.39 |