healthcosts.net
Ins pq tunnld ip cath w/img at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$8,416.80
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.
?
What you pay up front if you don't use insurance.
$14,028.00
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.
$2,234.51 with UPMC Work Partners vs $11,923.80 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 Work Partners | Workers Comp | $2,234.51 | ↓ -73% |
| UPMC Health Plan | Managed Medicare | $3,051.30 | ↓ -64% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,364.54 | ↓ -60% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,444.62 | ↓ -59% |
| Aetna | Medicare | $3,465.48 | ↓ -59% |
| Aetna of PA | Medicare | $3,532.77 | ↓ -58% |
| United Healthcare | Unison Advantage Non Special Needs | $3,532.77 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,633.37 | ↓ -57% |
| AmeriHealth Caritas | Medicare | $3,633.70 | ↓ -57% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,633.70 | ↓ -57% |
| United Healthcare | Unison Advantage Special Needs | $3,700.99 | ↓ -56% |
| InterGroup | PPO | $3,704.00 | ↓ -56% |
| UPMC Health Plan | Commercial | $4,162.80 | ↓ -51% |
| Aetna | EBR ASO | $5,611.20 | ↓ -33% |
| Cigna | Commercial | $5,611.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $7,064.46 | ↓ -16% |
| PA Health & Wellness | PA Medicaid HMO | $7,715.40 | ↓ -8% |
| Aetna | EBR FI | $8,136.24 | ↓ -3% |
| Aetna | Neighborhood Network | $8,416.80 | ↑ +0% |
| Aetna | Home Depot Employer Group | $8,655.28 | ↑ +3% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $8,703.95 | ↑ +3% |
| Aetna | NBR ASO/FI | $8,837.64 | ↑ +5% |
| Cigna | New Business ASO | $8,837.64 | ↑ +5% |
| Coventry/First Health | Commercial | $9,819.60 | ↑ +17% |
| Health Coalition Partners | PPO | $10,100.16 | ↑ +20% |
| Private Health Care Systems | PPO | $11,222.40 | ↑ +33% |
| Humana | Commercial | $11,923.80 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Ins pq tunnld ip cath w/img at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $14,346.00 | $2,234.51 – $20,323.50 |
| UPMC Mercy | Pittsburgh | $11,944.80 | $2,515.16 – $17,917.20 |
| UPMC Presbyterian | Pittsburgh | $11,676.60 | $931.20 – $16,541.85 |
| UPMC Somerset | Somerset | $11,758.20 | $892.40 – $14,697.75 |
| UPMC St. Margaret | Pittsburgh | $8,686.20 | $2,234.51 – $12,305.45 |
| UPMC Williamsport | Williamsport | $7,670.40 | $993.28 – $10,227.20 |