healthcosts.net
Ear irrigation 69209 at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$79.80
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.
$133.00
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.
$16.06 with UPMC Work Partners vs $115.74 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $16.06 | ↓ -80% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $21.76 | ↓ -73% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $26.81 | ↓ -66% |
| UPMC Health Plan | Managed Medicare | $51.36 | ↓ -36% |
| Aetna | EBR ASO | $53.20 | ↓ -33% |
| Cigna | Commercial | $53.20 | ↓ -33% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $56.63 | ↓ -29% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $57.98 | ↓ -27% |
| Aetna | Medicare | $58.33 | ↓ -27% |
| Aetna of PA | Medicare | $59.46 | ↓ -25% |
| United Healthcare | Unison Advantage Non Special Needs | $59.46 | ↓ -25% |
| Highmark Wholecare (prev Gateway) | Medicare | $61.15 | ↓ -23% |
| AmeriHealth Caritas | Medicare | $61.16 | ↓ -23% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $61.16 | ↓ -23% |
| United Healthcare | Unison Advantage Special Needs | $62.29 | ↓ -22% |
| PA Health & Wellness | PA Medicaid HMO | $73.15 | ↓ -8% |
| Aetna | EBR FI | $77.14 | ↓ -3% |
| Aetna | Neighborhood Network | $79.80 | ↑ +0% |
| Aetna | Home Depot Employer Group | $82.06 | ↑ +3% |
| Aetna | NBR ASO/FI | $83.79 | ↑ +5% |
| Cigna | New Business ASO | $83.79 | ↑ +5% |
| InterGroup | PPO | $86.45 | ↑ +8% |
| Coventry/First Health | Commercial | $93.10 | ↑ +17% |
| Health Coalition Partners | PPO | $95.76 | ↑ +20% |
| Private Health Care Systems | PPO | $106.40 | ↑ +33% |
| Humana | Commercial | $113.05 | ↑ +42% |
| UPMC Health Plan | Commercial | $115.74 | ↑ +45% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Ear irrigation 69209 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $137.40 | $8.46 – $194.65 |
| UPMC Mercy | Pittsburgh | $168.00 | $8.38 – $252.00 |
| UPMC Muncy | Muncy | $117.00 | $16.06 – $993.28 |
| UPMC Presbyterian | Pittsburgh | $169.20 | $8.46 – $931.20 |
| UPMC Somerset | Somerset | $214.80 | $8.30 – $892.40 |
| UPMC St. Margaret | Pittsburgh | $149.40 | $8.46 – $211.65 |
| UPMC Wellsboro | Wellsboro | $117.00 | $1.80 – $993.28 |
| UPMC Williamsport | Williamsport | $117.00 | $16.06 – $993.28 |