healthcosts.net
Injection epidural blood patch or clot at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$1,156.80
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.
$1,928.00
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.
$52.80 with UPMC Health Plan vs $1,742.87 with Highmark BCBS of PA — 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 | $52.80 | ↓ -95% |
| United Healthcare Community Plan for Families | Unison Kids | $55.20 | ↓ -95% |
| Aetna | Medicaid | $57.60 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $71.18 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $74.93 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $81.80 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $302.13 | ↓ -74% |
| UPMC Health Plan | Managed Medicare | $598.76 | ↓ -48% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $660.23 | ↓ -43% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $675.94 | ↓ -42% |
| Aetna | Medicare | $680.04 | ↓ -41% |
| United Healthcare | Unison Advantage Non Special Needs | $693.24 | ↓ -40% |
| Aetna of PA | Medicare | $693.24 | ↓ -40% |
| Highmark Wholecare (prev Gateway) | Medicare | $712.98 | ↓ -38% |
| AmeriHealth Caritas | Medicare | $713.05 | ↓ -38% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $713.05 | ↓ -38% |
| United Healthcare | Unison Advantage Special Needs | $726.25 | ↓ -37% |
| Cigna | Commercial | $771.20 | ↓ -33% |
| Aetna | EBR ASO | $771.20 | ↓ -33% |
| UPMC Health Plan | Commercial | $817.46 | ↓ -29% |
| Aetna | EBR FI | $1,118.24 | ↓ -3% |
| Aetna | Neighborhood Network | $1,156.80 | ↑ +0% |
| Aetna | Home Depot Employer Group | $1,189.58 | ↑ +3% |
| Aetna | NBR ASO/FI | $1,214.64 | ↑ +5% |
| Cigna | New Business ASO | $1,214.64 | ↑ +5% |
| InterGroup | PPO | $1,253.20 | ↑ +8% |
| Coventry/First Health | Commercial | $1,349.60 | ↑ +17% |
| Health Coalition Partners | PPO | $1,388.16 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,414.58 | ↑ +22% |
| Private Health Care Systems | PPO | $1,542.40 | ↑ +33% |
| Humana | Commercial | $1,638.80 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,742.87 | ↑ +51% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Injection epidural blood patch or clot at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,546.80 | $52.80 – $2,191.30 |
| UPMC Mercy | Pittsburgh | $2,056.80 | $52.80 – $3,085.20 |
| UPMC Muncy | Muncy | $1,470.60 | $52.80 – $1,960.80 |
| UPMC Presbyterian | Pittsburgh | $3,776.40 | $52.80 – $5,349.90 |
| UPMC Somerset | Somerset | $1,192.80 | $52.80 – $1,491.00 |
| UPMC St. Margaret | Pittsburgh | $1,313.40 | $52.80 – $1,860.65 |
| UPMC Wellsboro | Wellsboro | $1,470.60 | $52.80 – $993.28 |
| UPMC Williamsport | Williamsport | $1,470.60 | $52.80 – $1,960.80 |