Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
not published by hospital
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.
?
What you pay up front if you don't use insurance.
not published by hospital
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.
?
The hospital's undiscounted list price — almost no one pays this.
$44.00 with UPMC Health Plan vs $1,742.87 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $44.00 | — |
| United Healthcare Community Plan for Families | Unison Kids | $46.00 | — |
| Aetna | Medicaid | $48.00 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $59.32 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $62.44 | — |
| PA Health & Wellness | PA Medicaid HMO | $68.17 | — |
| UPMC Work Partners | Workers Comp | $154.19 | — |
| UPMC Health Plan | Commercial | $809.55 | — |
| UPMC Health Plan | Managed Medicare | $1,400.89 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,414.58 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,544.70 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,581.46 | — |
| Aetna | Medicare | $1,591.04 | — |
| United Healthcare | Unison Advantage Non Special Needs | $1,621.93 | — |
| Aetna of PA | Medicare | $1,621.93 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.12 | — |
| AmeriHealth Caritas | Medicare | $1,668.28 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | — |
| United Healthcare | Unison Advantage Special Needs | $1,699.17 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,742.87 | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $286.80 | $40.00 – $545.04 |
| UPMC Carlisle | Carlisle | $2,080.80 | $50.80 – $2,947.80 |
| UPMC Cole | Coudersport | $1,020.00 | $22.18 – $2,094.25 |
| UPMC Community Osteopathic | Harrisburg | $2,080.80 | $50.80 – $2,947.80 |
| UPMC Hanover | Hanover | $2,080.80 | $50.80 – $2,476.51 |
| UPMC Kane | Kane | $1,273.20 | $44.00 – $532.29 |
| UPMC Lititz | Lititz | $2,080.80 | $50.80 – $2,489.89 |
| UPMC Magee | Pittsburgh | $1,896.00 | $44.00 – $1,668.28 |