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Mycophenolate mofetil 250 mg capsule at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$34.40
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.
$43.00
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.
$0.10 with UPMC Health Plan vs $36.55 with Humana — 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 | $0.10 | ↓ -100% |
| Geisinger | Medicaid/CHIP | $0.16 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicaid | $0.16 | ↓ -100% |
| PA Health & Wellness | PA Medicaid HMO | $0.16 | ↓ -100% |
| UPMC Health Plan | Commercial | $0.19 | ↓ -99% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $10.32 | ↓ -70% |
| Aetna | Medicare | $10.75 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $12.72 | ↓ -63% |
| UPMC Work Partners | Workers Comp | $15.53 | ↓ -55% |
| Aetna | EBR ASO | $17.20 | ↓ -50% |
| Cigna | Commercial | $17.20 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicare | $21.50 | ↓ -38% |
| Aetna | EBR FI | $24.94 | ↓ -28% |
| Aetna | Neighborhood Network | $25.80 | ↓ -25% |
| Aetna | Home Depot Employer Group | $26.53 | ↓ -23% |
| Aetna | NBR ASO/FI | $27.09 | ↓ -21% |
| Cigna | New Business ASO | $27.09 | ↓ -21% |
| InterGroup | PPO | $27.95 | ↓ -19% |
| Coventry/First Health | Commercial | $30.10 | ↓ -13% |
| Health Coalition Partners | PPO | $30.96 | ↓ -10% |
| Private Health Care Systems | PPO | $34.40 | ↑ +0% |
| Humana | Commercial | $36.55 | ↑ +6% |
Visitor-reported prices
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Mycophenolate mofetil 250 mg capsule at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $18.60 | $0.10 – $13.50 |
| UPMC Muncy | Muncy | $120.00 | $0.16 – $6.30 |
| UPMC Passavant-McCandless | Pittsburgh | $100.20 | $0.10 – $22.95 |
| UPMC Presbyterian | Pittsburgh | $273.60 | $0.10 – $130.05 |
| UPMC Somerset | Somerset | $10.20 | $0.16 – $3.94 |
| UPMC St. Margaret | Pittsburgh | $57.80 | $0.10 – $25.50 |
| UPMC Wellsboro | Wellsboro | $120.00 | $0.16 – $6.30 |
| UPMC Western Psychiatric | Pittsburgh | $100.20 | $0.16 – $130.05 |