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Implant cartilage 10mm synthetic at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$7,867.80
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.
$13,113.00
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.
$76.25 with Aetna vs $4,091.18 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 | $76.25 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $100.65 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $103.18 | ↓ -99% |
| Aetna | EBR ASO | $122.00 | ↓ -98% |
| Cigna | Commercial | $122.00 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $122.00 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicare | $152.50 | ↓ -98% |
| Aetna | EBR FI | $176.90 | ↓ -98% |
| Aetna | Neighborhood Network | $183.00 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $183.00 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $183.00 | ↓ -98% |
| Aetna | Home Depot Employer Group | $188.19 | ↓ -98% |
| Aetna | NBR ASO/FI | $192.15 | ↓ -98% |
| Cigna | New Business ASO | $192.15 | ↓ -98% |
| InterGroup | PPO | $198.25 | ↓ -97% |
| Coventry/First Health | Commercial | $213.50 | ↓ -97% |
| Health Coalition Partners | PPO | $219.60 | ↓ -97% |
| Private Health Care Systems | PPO | $244.00 | ↓ -97% |
| Humana | Commercial | $259.25 | ↓ -97% |
| UPMC Health Plan | Commercial | $4,091.18 | ↓ -48% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Implant cartilage 10mm synthetic at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $24,575.40 | $38.40 – $2,669.69 |
| UPMC Muncy | Muncy | $7,003.80 | $33.75 – $202.50 |
| UPMC Passavant-McCandless | Pittsburgh | $17,191.20 | $44.44 – $4,906.09 |
| UPMC Presbyterian | Pittsburgh | $31,672.20 | $1.92 – $5,466.29 |
| UPMC St. Margaret | Pittsburgh | $18,039.00 | $42.80 – $4,148.59 |
| UPMC Wellsboro | Wellsboro | $8,470.40 | $36.72 – $183.60 |
| UPMC Williamsport | Williamsport | $12,413.40 | $28.89 – $96.30 |