healthcosts.net
Inj., guselkumab, 1 mg at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$695.20
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.
?
What you pay up front if you don't use insurance.
$869.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$47.97 with UPMC Health Plan vs $552.50 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $47.97 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $68.90 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $75.97 | ↓ -89% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $75.97 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $75.97 | ↓ -89% |
| PA Health & Wellness | PA Medicaid HMO | $75.97 | ↓ -89% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $77.78 | ↓ -89% |
| Aetna | Medicare | $78.25 | ↓ -89% |
| Aetna of PA | Medicare | $79.77 | ↓ -89% |
| United Healthcare | Unison Advantage Non Special Needs | $79.77 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicare | $82.04 | ↓ -88% |
| AmeriHealth Caritas | Medicare | $82.05 | ↓ -88% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $82.05 | ↓ -88% |
| United Healthcare | Unison Advantage Special Needs | $83.57 | ↓ -88% |
| UPMC Health Plan | Commercial | $93.45 | ↓ -87% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $168.95 | ↓ -76% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $208.16 | ↓ -70% |
| UPMC Work Partners | Workers Comp | $234.72 | ↓ -66% |
| Aetna | EBR ASO | $260.00 | ↓ -63% |
| Cigna | Commercial | $260.00 | ↓ -63% |
| Aetna | EBR FI | $377.00 | ↓ -46% |
| Aetna | Neighborhood Network | $390.00 | ↓ -44% |
| Aetna | Home Depot Employer Group | $401.05 | ↓ -42% |
| Aetna | NBR ASO/FI | $409.50 | ↓ -41% |
| Cigna | New Business ASO | $409.50 | ↓ -41% |
| InterGroup | PPO | $422.50 | ↓ -39% |
| Coventry/First Health | Commercial | $455.00 | ↓ -35% |
| Health Coalition Partners | PPO | $468.00 | ↓ -33% |
| Private Health Care Systems | PPO | $520.00 | ↓ -25% |
| Humana | Commercial | $552.50 | ↓ -21% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Inj., guselkumab, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $675.00 | $47.97 – $197.20 |
| UPMC Presbyterian | Pittsburgh | $675.00 | $47.97 – $956.25 |
| UPMC Western Psychiatric | Pittsburgh | $675.00 | $64.39 – $956.25 |