healthcosts.net
Knee MRI (with contrast) at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$2,449.80
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.
$4,083.00
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.
$354.99 with UPMC Health Plan vs $3,470.55 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 | Commercial | $354.99 | ↓ -86% |
| UPMC Health Plan | Managed Medicare | $683.10 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $753.23 | ↓ -69% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $771.16 | ↓ -69% |
| Aetna | Medicare | $775.83 | ↓ -68% |
| Aetna of PA | Medicare | $790.89 | ↓ -68% |
| United Healthcare | Unison Advantage Non Special Needs | $790.89 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $813.41 | ↓ -67% |
| AmeriHealth Caritas | Medicare | $813.49 | ↓ -67% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $813.49 | ↓ -67% |
| United Healthcare | Unison Advantage Special Needs | $828.55 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $1,109.81 | ↓ -55% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,400.88 | ↓ -43% |
| Aetna | EBR ASO | $1,633.20 | ↓ -33% |
| Cigna | Commercial | $1,633.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,725.99 | ↓ -30% |
| PA Health & Wellness | PA Medicaid HMO | $2,245.65 | ↓ -8% |
| Aetna | EBR FI | $2,368.14 | ↓ -3% |
| Aetna | Neighborhood Network | $2,449.80 | ↑ +0% |
| Aetna | Home Depot Employer Group | $2,519.21 | ↑ +3% |
| Aetna | NBR ASO/FI | $2,572.29 | ↑ +5% |
| Cigna | New Business ASO | $2,572.29 | ↑ +5% |
| InterGroup | PPO | $2,653.95 | ↑ +8% |
| Coventry/First Health | Commercial | $2,858.10 | ↑ +17% |
| Health Coalition Partners | PPO | $2,939.76 | ↑ +20% |
| Private Health Care Systems | PPO | $3,266.40 | ↑ +33% |
| Humana | Commercial | $3,470.55 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Knee MRI (with contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,621.20 | $354.83 – $6,546.70 |
| UPMC East | Monroeville | $5,074.20 | $351.73 – $6,765.60 |
| UPMC Hamot | Erie | $1,948.80 | $201.09 – $2,273.60 |
| UPMC Jameson | New Castle | $3,019.80 | $327.85 – $4,178.24 |
| UPMC Carlisle | Carlisle | $2,713.80 | $403.15 – $3,844.55 |
| UPMC Bedford | Everett | $1,705.20 | $271.77 – $2,557.80 |
| UPMC Altoona | Altoona | $2,119.20 | $425.00 – $2,825.60 |
| UPMC Cole | Coudersport | $1,384.20 | $379.08 – $1,845.60 |