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Diphtheria-tetanus toxoids 0.5 ml (peds) at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$24.60
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.
$41.00
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.
$10.25 with Aetna vs $47.50 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | Medicare | $10.25 | ↓ -58% |
| UPMC Health Plan | Managed Medicaid | $11.00 | ↓ -55% |
| United Healthcare Community Plan for Families | Unison Kids | $11.50 | ↓ -53% |
| Aetna | Medicaid | $12.00 | ↓ -51% |
| UPMC Work Partners | Workers Comp | $14.81 | ↓ -40% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.83 | ↓ -40% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.61 | ↓ -37% |
| Aetna | EBR ASO | $16.40 | ↓ -33% |
| Cigna | Commercial | $16.40 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $17.04 | ↓ -31% |
| Highmark Wholecare (prev Gateway) | Medicare | $20.50 | ↓ -17% |
| Aetna | EBR FI | $23.78 | ↓ -3% |
| Aetna | Neighborhood Network | $24.60 | ↑ +0% |
| Aetna | Home Depot Employer Group | $25.30 | ↑ +3% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $25.76 | ↑ +5% |
| Aetna | NBR ASO/FI | $25.83 | ↑ +5% |
| Cigna | New Business ASO | $25.83 | ↑ +5% |
| InterGroup | PPO | $26.65 | ↑ +8% |
| Coventry/First Health | Commercial | $28.70 | ↑ +17% |
| Health Coalition Partners | PPO | $29.52 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $31.74 | ↑ +29% |
| Private Health Care Systems | PPO | $32.80 | ↑ +33% |
| Humana | Commercial | $34.85 | ↑ +42% |
| UPMC Health Plan | Commercial | $47.50 | ↑ +93% |
Visitor-reported prices
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Diphtheria-tetanus toxoids 0.5 ml (peds) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $24.60 | $9.93 – $36.90 |
| UPMC Muncy | Muncy | $24.60 | $6.15 – $36.90 |
| UPMC Wellsboro | Wellsboro | $25.80 | $7.38 – $36.90 |
| UPMC Williamsport | Williamsport | $24.60 | $11.00 – $36.90 |