healthcosts.net
Octreotide,microspheres ER 20 mg intramuscular susp, extended release at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$571.20
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.
$15,486.40
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.
$128.54 with UPMC Health Plan vs $5,332.47 with Aetna — 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 | $128.54 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $184.63 | ↓ -68% |
| UPMC Work Partners | Workers Comp | $188.24 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $203.58 | ↓ -64% |
| PA Health & Wellness | PA Medicaid HMO | $203.58 | ↓ -64% |
| Geisinger | Medicaid/CHIP | $203.58 | ↓ -64% |
| Highmark Wholecare (prev Gateway) | Medicaid | $203.58 | ↓ -64% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $208.43 | ↓ -64% |
| Cigna | Commercial | $208.52 | ↓ -63% |
| Aetna | EBR ASO | $208.52 | ↓ -63% |
| Aetna | Medicare | $209.69 | ↓ -63% |
| United Healthcare | Unison Advantage Non Special Needs | $213.76 | ↓ -63% |
| Aetna of PA | Medicare | $213.76 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicare | $219.85 | ↓ -62% |
| AmeriHealth Caritas | Medicare | $219.87 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $219.87 | ↓ -62% |
| United Healthcare | Unison Advantage Special Needs | $223.94 | ↓ -61% |
| UPMC Health Plan | Commercial | $250.41 | ↓ -56% |
| Aetna | EBR FI | $302.35 | ↓ -47% |
| Aetna | Neighborhood Network | $312.78 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $316.43 | ↓ -45% |
| Aetna | Home Depot Employer Group | $321.64 | ↓ -44% |
| Aetna | NBR ASO/FI | $328.42 | ↓ -43% |
| Cigna | New Business ASO | $328.42 | ↓ -43% |
| InterGroup | PPO | $338.85 | ↓ -41% |
| Coventry/First Health | Commercial | $364.91 | ↓ -36% |
| Health Coalition Partners | PPO | $375.34 | ↓ -34% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $389.86 | ↓ -32% |
| Private Health Care Systems | PPO | $417.04 | ↓ -27% |
| Humana | Commercial | $443.11 | ↓ -22% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $4,665.91 | ↑ +717% |
| United Healthcare Community Plan for Families | Unison Kids | $5,110.28 | ↑ +795% |
| Aetna | Medicaid | $5,332.47 | ↑ +834% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Octreotide,microspheres ER 20 mg intramuscular susp, extended release at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $8,451.00 | $128.54 – $5,110.28 |
| UPMC Muncy | Muncy | $28,302.00 | $203.58 – $1,417.50 |
| UPMC Passavant-McCandless | Pittsburgh | $23,098.20 | $128.54 – $4,665.91 |
| UPMC Presbyterian | Pittsburgh | $30,309.60 | $128.54 – $4,443.72 |
| UPMC Somerset | Somerset | $4,066.20 | $170.53 – $2,590.50 |
| UPMC St. Margaret | Pittsburgh | $7,328.40 | $128.54 – $4,888.09 |
| UPMC Wellsboro | Wellsboro | $28,302.00 | $203.58 – $4,443.72 |
| UPMC Western Psychiatric | Pittsburgh | $1,515.00 | $170.42 – $1,430.55 |