healthcosts.net
Inj retro urethrocysto at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$3,582.00
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.
$5,970.00
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.
$37.95 with UPMC Health Plan vs $5,074.50 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 | $37.95 | ↓ -99% |
| United Healthcare Community Plan for Families | Unison Kids | $39.67 | ↓ -99% |
| Aetna | Medicaid | $41.40 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $51.16 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $53.86 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $58.79 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $142.91 | ↓ -96% |
| UPMC Health Plan | Commercial | $1,246.76 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,414.58 | ↓ -61% |
| Aetna | Medicare | $1,492.50 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,742.87 | ↓ -51% |
| Aetna | EBR ASO | $2,388.00 | ↓ -33% |
| Cigna | Commercial | $2,388.00 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,985.00 | ↓ -17% |
| Aetna | EBR FI | $3,462.60 | ↓ -3% |
| Aetna | Neighborhood Network | $3,582.00 | ↑ +0% |
| Aetna | Home Depot Employer Group | $3,683.49 | ↑ +3% |
| InterGroup | PPO | $3,704.00 | ↑ +3% |
| Aetna | NBR ASO/FI | $3,761.10 | ↑ +5% |
| Cigna | New Business ASO | $3,761.10 | ↑ +5% |
| Coventry/First Health | Commercial | $4,179.00 | ↑ +17% |
| Health Coalition Partners | PPO | $4,298.40 | ↑ +20% |
| Private Health Care Systems | PPO | $4,776.00 | ↑ +33% |
| Humana | Commercial | $5,074.50 | ↑ +42% |
Visitor-reported prices
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Inj retro urethrocysto at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $2,236.20 | $37.95 – $3,354.30 |
| UPMC Muncy | Muncy | $3,691.20 | $37.95 – $4,921.60 |
| UPMC Presbyterian | Pittsburgh | $4,057.80 | $37.95 – $5,748.55 |
| UPMC Somerset | Somerset | $504.00 | $37.95 – $630.00 |
| UPMC St. Margaret | Pittsburgh | $2,981.40 | $37.95 – $4,223.65 |
| UPMC Wellsboro | Wellsboro | $4,464.00 | $37.95 – $5,022.00 |
| UPMC Williamsport | Williamsport | $3,691.20 | $37.95 – $4,921.60 |