healthcosts.net
Pfc sigma fem post aug sz3 8mm at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$26,256.60
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.
$43,761.00
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.
$84.25 with Aetna vs $4,976.39 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 | Medicare | $84.25 | ↓ -100% |
| PA Health & Wellness | PA Medicaid HMO | $111.21 | ↓ -100% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $114.01 | ↓ -100% |
| Aetna | EBR ASO | $134.80 | ↓ -99% |
| Cigna | Commercial | $134.80 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $134.80 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $168.50 | ↓ -99% |
| Aetna | EBR FI | $195.46 | ↓ -99% |
| Aetna | Neighborhood Network | $202.20 | ↓ -99% |
| Aetna | Home Depot Employer Group | $207.93 | ↓ -99% |
| Aetna | NBR ASO/FI | $212.31 | ↓ -99% |
| Cigna | New Business ASO | $212.31 | ↓ -99% |
| InterGroup | PPO | $219.05 | ↓ -99% |
| Coventry/First Health | Commercial | $235.90 | ↓ -99% |
| Health Coalition Partners | PPO | $242.64 | ↓ -99% |
| Private Health Care Systems | PPO | $269.60 | ↓ -99% |
| Humana | Commercial | $286.45 | ↓ -99% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,072.09 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,552.96 | ↓ -90% |
| UPMC Health Plan | Commercial | $4,976.39 | ↓ -81% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Pfc sigma fem post aug sz3 8mm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $52,519.80 | $50.16 – $3,247.34 |
| UPMC Muncy | Muncy | $19,378.20 | $115.20 – $691.20 |
| UPMC Passavant-McCandless | Pittsburgh | $30,931.20 | $45.98 – $5,967.63 |
| UPMC Presbyterian | Pittsburgh | $62,313.60 | $20.64 – $6,649.04 |
| UPMC St. Margaret | Pittsburgh | $38,883.60 | $37.20 – $5,046.23 |
| UPMC Wellsboro | Wellsboro | $22,916.00 | $16.38 – $81.90 |
| UPMC Williamsport | Williamsport | $23,848.80 | $19.00 – $85.50 |