healthcosts.net
Gamunex-c/gammaked at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$345.60
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.
$2,896.33
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.
$30.92 with UPMC Health Plan vs $364.65 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 | $30.92 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $44.40 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $48.96 | ↓ -86% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $48.96 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $48.96 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $48.96 | ↓ -86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $50.13 | ↓ -85% |
| Aetna | Medicare | $50.43 | ↓ -85% |
| Aetna of PA | Medicare | $51.41 | ↓ -85% |
| United Healthcare | Unison Advantage Non Special Needs | $51.41 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $52.87 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $52.88 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $52.88 | ↓ -85% |
| United Healthcare | Unison Advantage Special Needs | $53.86 | ↓ -84% |
| UPMC Health Plan | Commercial | $60.23 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $154.91 | ↓ -55% |
| Aetna | EBR ASO | $171.60 | ↓ -50% |
| Cigna | Commercial | $171.60 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $237.74 | ↓ -31% |
| Aetna | EBR FI | $248.82 | ↓ -28% |
| Aetna | Neighborhood Network | $257.40 | ↓ -26% |
| Aetna | Home Depot Employer Group | $264.69 | ↓ -23% |
| Aetna | NBR ASO/FI | $270.27 | ↓ -22% |
| Cigna | New Business ASO | $270.27 | ↓ -22% |
| InterGroup | PPO | $278.85 | ↓ -19% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $292.92 | ↓ -15% |
| Coventry/First Health | Commercial | $300.30 | ↓ -13% |
| Health Coalition Partners | PPO | $308.88 | ↓ -11% |
| Private Health Care Systems | PPO | $343.20 | ↓ -1% |
| Humana | Commercial | $364.65 | ↑ +6% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Gamunex-c/gammaked at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $345.60 | $30.92 – $386.10 |
| UPMC Presbyterian | Pittsburgh | $260.40 | $30.92 – $364.65 |
| UPMC St. Margaret | Pittsburgh | $450.40 | $30.92 – $478.55 |
| UPMC Western Psychiatric | Pittsburgh | $259.20 | $48.96 – $364.65 |
| UPMC Williamsport | Williamsport | $338.40 | $48.96 – $345.60 |