healthcosts.net
Fem/popl revasc w/stent at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$34,620.00
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.
$57,700.00
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.
$3,704.00 with InterGroup vs $51,397.79 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 |
|---|---|---|---|
| InterGroup | PPO | $3,704.00 | ↓ -89% |
| UPMC Health Plan | Managed Medicare | $9,805.28 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $10,811.87 | ↓ -69% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,069.19 | ↓ -68% |
| Aetna | Medicare | $11,136.23 | ↓ -68% |
| Aetna of PA | Medicare | $11,352.46 | ↓ -67% |
| United Healthcare | Unison Advantage Non Special Needs | $11,352.46 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,675.74 | ↓ -66% |
| AmeriHealth Caritas | Medicare | $11,676.82 | ↓ -66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,676.82 | ↓ -66% |
| United Healthcare | Unison Advantage Special Needs | $11,893.06 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $13,195.02 | ↓ -62% |
| UPMC Health Plan | Commercial | $14,880.43 | ↓ -57% |
| Aetna | EBR ASO | $23,080.00 | ↓ -33% |
| Cigna | Commercial | $23,080.00 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $31,735.00 | ↓ -8% |
| Aetna | EBR FI | $33,466.00 | ↓ -3% |
| Aetna | Neighborhood Network | $34,620.00 | ↑ +0% |
| Aetna | Home Depot Employer Group | $35,600.90 | ↑ +3% |
| Aetna | NBR ASO/FI | $36,351.00 | ↑ +5% |
| Cigna | New Business ASO | $36,351.00 | ↑ +5% |
| Coventry/First Health | Commercial | $40,390.00 | ↑ +17% |
| Health Coalition Partners | PPO | $41,544.00 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $41,716.45 | ↑ +20% |
| Private Health Care Systems | PPO | $46,160.00 | ↑ +33% |
| Humana | Commercial | $49,045.00 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $51,397.79 | ↑ +48% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Fem/popl revasc w/stent at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $38,983.80 | $10,047.47 – $55,227.05 |
| UPMC Mercy | Pittsburgh | $34,849.20 | $468.11 – $52,273.80 |
| UPMC Presbyterian | Pittsburgh | $41,308.20 | $468.11 – $58,519.95 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC St. Margaret | Pittsburgh | $35,730.60 | $9,334.97 – $50,618.35 |
| UPMC Williamsport | Williamsport | $7,915.20 | $993.28 – $13,195.02 |