healthcosts.net
Injection, fulvestrant at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$6,048.60
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.
$10,081.00
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.
$4.25 with UPMC Health Plan vs $342.90 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 | $4.25 | ↓ -100% |
| UPMC Health Plan | Managed Medicare | $6.10 | ↓ -100% |
| Geisinger | Medicaid/CHIP | $6.73 | ↓ -100% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $6.73 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicaid | $6.73 | ↓ -100% |
| PA Health & Wellness | PA Medicaid HMO | $6.73 | ↓ -100% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $6.89 | ↓ -100% |
| Aetna | Medicare | $6.93 | ↓ -100% |
| Aetna of PA | Medicare | $7.07 | ↓ -100% |
| United Healthcare | Unison Advantage Non Special Needs | $7.07 | ↓ -100% |
| AmeriHealth Caritas | Medicare | $7.27 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicare | $7.27 | ↓ -100% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $7.27 | ↓ -100% |
| United Healthcare | Unison Advantage Special Needs | $7.40 | ↓ -100% |
| UPMC Health Plan | Commercial | $8.28 | ↓ -100% |
| UPMC Work Partners | Workers Comp | $54.00 | ↓ -99% |
| Aetna | EBR ASO | $59.81 | ↓ -99% |
| Cigna | Commercial | $59.81 | ↓ -99% |
| Aetna | EBR FI | $86.73 | ↓ -99% |
| Aetna | Neighborhood Network | $89.72 | ↓ -99% |
| Aetna | Home Depot Employer Group | $92.26 | ↓ -98% |
| Aetna | NBR ASO/FI | $94.20 | ↓ -98% |
| Cigna | New Business ASO | $94.20 | ↓ -98% |
| InterGroup | PPO | $97.19 | ↓ -98% |
| Coventry/First Health | Commercial | $104.67 | ↓ -98% |
| Health Coalition Partners | PPO | $107.66 | ↓ -98% |
| Private Health Care Systems | PPO | $119.62 | ↓ -98% |
| Humana | Commercial | $127.10 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $278.31 | ↓ -95% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $342.90 | ↓ -94% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Injection, fulvestrant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,940.80 | $4.25 – $166.75 |
| UPMC Muncy | Muncy | $4,423.20 | $6.73 – $663.30 |
| UPMC Passavant-McCandless | Pittsburgh | $4,829.40 | $4.25 – $250.75 |
| UPMC Presbyterian | Pittsburgh | $9,219.60 | $4.25 – $1,305.60 |
| UPMC St. Margaret | Pittsburgh | $912.80 | $4.25 – $168.34 |
| UPMC Wellsboro | Wellsboro | $4,423.20 | $6.73 – $663.30 |
| UPMC Western Psychiatric | Pittsburgh | $921.60 | $6.73 – $1,305.60 |
| UPMC Williamsport | Williamsport | $589.60 | $6.73 – $663.30 |