healthcosts.net
Graft xenmtrx sft rect 19x28cm at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$255.00
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.
$425.00
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.
$100.25 with Aetna vs $1,471.99 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 | $100.25 | ↓ -61% |
| PA Health & Wellness | PA Medicaid HMO | $132.33 | ↓ -48% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $135.66 | ↓ -47% |
| Aetna | EBR ASO | $160.40 | ↓ -37% |
| Cigna | Commercial | $160.40 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicaid | $160.40 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $200.50 | ↓ -21% |
| Aetna | EBR FI | $232.58 | ↓ -9% |
| Aetna | Neighborhood Network | $240.60 | ↓ -6% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $240.60 | ↓ -6% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $240.60 | ↓ -6% |
| Aetna | Home Depot Employer Group | $247.42 | ↓ -3% |
| Aetna | NBR ASO/FI | $252.63 | ↓ -1% |
| Cigna | New Business ASO | $252.63 | ↓ -1% |
| InterGroup | PPO | $260.65 | ↑ +2% |
| Coventry/First Health | Commercial | $280.70 | ↑ +10% |
| Health Coalition Partners | PPO | $288.72 | ↑ +13% |
| Private Health Care Systems | PPO | $320.80 | ↑ +26% |
| Humana | Commercial | $340.85 | ↑ +34% |
| UPMC Health Plan | Commercial | $1,471.99 | ↑ +477% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Graft xenmtrx sft rect 19x28cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,076.20 | $51.12 – $960.55 |
| UPMC Muncy | Muncy | $2,112.60 | $76.05 – $456.30 |
| UPMC Passavant-McCandless | Pittsburgh | $3,260.40 | $38.28 – $1,765.19 |
| UPMC Presbyterian | Pittsburgh | $3,166.80 | $21.00 – $1,966.75 |
| UPMC Somerset | Somerset | $461.40 | $116.20 – $728.60 |
| UPMC St. Margaret | Pittsburgh | $3,827.40 | $32.80 – $1,492.65 |
| UPMC Wellsboro | Wellsboro | $2,112.60 | $44.46 – $222.30 |
| UPMC Williamsport | Williamsport | $2,112.60 | $49.40 – $222.30 |