healthcosts.net
Mopath procedure level 1 at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$837.60
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.
$1,396.00
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.
$58.01 with UPMC Health Plan vs $610.91 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 Medicare | $58.01 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $63.21 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $63.96 | ↓ -92% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $63.96 | ↓ -92% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $65.48 | ↓ -92% |
| Aetna | Medicare | $65.88 | ↓ -92% |
| Aetna of PA | Medicare | $67.16 | ↓ -92% |
| United Healthcare | Unison Advantage Non Special Needs | $67.16 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $69.07 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $69.08 | ↓ -92% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $69.08 | ↓ -92% |
| United Healthcare | Unison Advantage Special Needs | $70.36 | ↓ -92% |
| UPMC Health Plan | Commercial | $86.15 | ↓ -90% |
| Aetna | EBR ASO | $207.60 | ↓ -75% |
| Cigna | Commercial | $207.60 | ↓ -75% |
| PA Health & Wellness | PA Medicaid HMO | $285.45 | ↓ -66% |
| Aetna | EBR FI | $301.02 | ↓ -64% |
| Aetna | Neighborhood Network | $311.40 | ↓ -63% |
| Aetna | Home Depot Employer Group | $320.22 | ↓ -62% |
| Aetna | NBR ASO/FI | $326.97 | ↓ -61% |
| Cigna | New Business ASO | $326.97 | ↓ -61% |
| InterGroup | PPO | $337.35 | ↓ -60% |
| Coventry/First Health | Commercial | $363.30 | ↓ -57% |
| Health Coalition Partners | PPO | $373.68 | ↓ -55% |
| Private Health Care Systems | PPO | $415.20 | ↓ -50% |
| Humana | Commercial | $441.15 | ↓ -47% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $495.84 | ↓ -41% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $610.91 | ↓ -27% |
Visitor-reported prices
Comments
Mopath procedure level 1 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,328.40 | $59.44 – $431.80 |
| UPMC Mercy | Pittsburgh | $1,253.40 | $53.32 – $457.20 |
| UPMC Muncy | Muncy | $238.80 | $49.95 – $318.40 |
| UPMC Presbyterian | Pittsburgh | $1,476.00 | $46.82 – $340.85 |
| UPMC Somerset | Somerset | $138.60 | $44.87 – $163.50 |
| UPMC St. Margaret | Pittsburgh | $837.60 | $55.22 – $431.80 |
| UPMC Wellsboro | Wellsboro | $303.20 | $49.95 – $341.10 |
| UPMC Williamsport | Williamsport | $1,434.60 | $49.95 – $393.60 |