healthcosts.net
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$55.20
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.
$92.00
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.
$18.93 with UPMC Health Plan vs $62.47 with Highmark BCBS of PA — 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 | $18.93 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $23.91 | ↓ -57% |
| Aetna | EBR ASO | $26.49 | ↓ -52% |
| Cigna | Commercial | $26.49 | ↓ -52% |
| UPMC Health Plan | Managed Medicare | $27.19 | ↓ -51% |
| Geisinger | Medicaid/CHIP | $29.98 | ↓ -46% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $29.98 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.98 | ↓ -46% |
| PA Health & Wellness | PA Medicaid HMO | $29.98 | ↓ -46% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $30.69 | ↓ -44% |
| Aetna | Medicare | $30.88 | ↓ -44% |
| Aetna of PA | Medicare | $31.48 | ↓ -43% |
| United Healthcare | Unison Advantage Non Special Needs | $31.48 | ↓ -43% |
| AmeriHealth Caritas | Medicare | $32.38 | ↓ -41% |
| Highmark Wholecare (prev Gateway) | Medicare | $32.38 | ↓ -41% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $32.38 | ↓ -41% |
| United Healthcare | Unison Advantage Special Needs | $32.98 | ↓ -40% |
| UPMC Health Plan | Commercial | $36.87 | ↓ -33% |
| Aetna | EBR FI | $38.41 | ↓ -30% |
| Aetna | Neighborhood Network | $39.73 | ↓ -28% |
| Aetna | Home Depot Employer Group | $40.86 | ↓ -26% |
| Aetna | NBR ASO/FI | $41.72 | ↓ -24% |
| Cigna | New Business ASO | $41.72 | ↓ -24% |
| InterGroup | PPO | $43.04 | ↓ -22% |
| Coventry/First Health | Commercial | $46.35 | ↓ -16% |
| Health Coalition Partners | PPO | $47.68 | ↓ -14% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $50.70 | ↓ -8% |
| Private Health Care Systems | PPO | $52.98 | ↓ -4% |
| Humana | Commercial | $56.29 | ↑ +2% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $62.47 | ↑ +13% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Fam-trastuzumab deruxtecan-nxki 100 mg intravenous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $55.20 | $18.48 – $59.60 |
| UPMC Passavant-McCandless | Pittsburgh | $55.20 | $18.93 – $78.20 |
| UPMC Somerset | Somerset | $1,620.60 | $19.34 – $2,025.75 |
| UPMC Wellsboro | Wellsboro | $52.80 | $15.84 – $79.20 |
| UPMC Williamsport | Williamsport | $52.80 | $23.87 – $79.20 |
| UPMC St. Margaret | Pittsburgh | not published | $16.69 – $56.29 |