Hysteroscopy ablation at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
not published by hospital
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.
not published by hospital
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.
$347.49 with UPMC Health Plan vs $5,176.94 with United Healthcare — 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 | $347.49 | — |
| United Healthcare Community Plan for Families | Unison Kids | $363.29 | — |
| Aetna | Medicaid | $379.08 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $468.48 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $493.15 | — |
| PA Health & Wellness | PA Medicaid HMO | $538.36 | — |
| UPMC Work Partners | Workers Comp | $763.39 | — |
| UPMC Health Plan | Commercial | $1,245.51 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,172.24 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,676.36 | — |
| UPMC Health Plan | Managed Medicare | $4,268.15 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $4,706.31 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $4,818.32 | — |
| Aetna | Medicare | $4,847.50 | — |
| Aetna of PA | Medicare | $4,941.63 | — |
| United Healthcare | Unison Advantage Non Special Needs | $4,941.63 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $5,082.34 | — |
| AmeriHealth Caritas | Medicare | $5,082.81 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5,082.81 | — |
| United Healthcare | Unison Advantage Special Needs | $5,176.94 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Hysteroscopy ablation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | not published | $347.49 – $5,176.94 |
| UPMC Wellsboro | Wellsboro | not published | $347.49 – $993.28 |