healthcosts.net
Mopath procedure level 9 at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$3,327.60
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.
$5,546.00
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.
$246.40 with Aetna vs $8,443.62 with UPMC Health Plan — 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 |
|---|---|---|---|
| Aetna | EBR ASO | $246.40 | ↓ -93% |
| Cigna | Commercial | $246.40 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $338.80 | ↓ -90% |
| Aetna | EBR FI | $357.28 | ↓ -89% |
| Aetna | Neighborhood Network | $369.60 | ↓ -89% |
| Aetna | Home Depot Employer Group | $380.07 | ↓ -89% |
| Aetna | NBR ASO/FI | $388.08 | ↓ -88% |
| Cigna | New Business ASO | $388.08 | ↓ -88% |
| InterGroup | PPO | $400.40 | ↓ -88% |
| Coventry/First Health | Commercial | $431.20 | ↓ -87% |
| Health Coalition Partners | PPO | $443.52 | ↓ -87% |
| Private Health Care Systems | PPO | $492.80 | ↓ -85% |
| Humana | Commercial | $523.60 | ↓ -84% |
| UPMC Health Plan | Managed Medicare | $1,813.80 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $1,976.64 | ↓ -41% |
| Geisinger | Medicaid/CHIP | $2,000.00 | ↓ -40% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,000.00 | ↓ -40% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $2,047.60 | ↓ -38% |
| Aetna | Medicare | $2,060.00 | ↓ -38% |
| Aetna of PA | Medicare | $2,100.00 | ↓ -37% |
| United Healthcare | Unison Advantage Non Special Needs | $2,100.00 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,159.80 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $2,160.00 | ↓ -35% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,160.00 | ↓ -35% |
| United Healthcare | Unison Advantage Special Needs | $2,200.00 | ↓ -34% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $6,611.37 | ↑ +99% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $8,145.70 | ↑ +145% |
| UPMC Health Plan | Commercial | $8,443.62 | ↑ +154% |
Visitor-reported prices
Comments
Mopath procedure level 9 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,422.60 | $36.38 – $2,571.61 |
| UPMC Mercy | Pittsburgh | $1,947.00 | $171.86 – $2,547.36 |
| UPMC Muncy | Muncy | $1,819.20 | $454.80 – $2,425.60 |
| UPMC Presbyterian | Pittsburgh | $4,171.80 | $40.32 – $5,748.40 |
| UPMC St. Margaret | Pittsburgh | $1,947.00 | $155.23 – $2,571.61 |
| UPMC Wellsboro | Wellsboro | $4,626.40 | $545.76 – $2,728.80 |
| UPMC Williamsport | Williamsport | $4,017.00 | $1,203.55 – $2,547.20 |