healthcosts.net
Prcrd drg 6+yr without anomly at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$3,943.80
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.
$6,573.00
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.
$303.07 with UPMC Work Partners vs $5,587.05 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 Work Partners | Workers Comp | $303.07 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $365.15 | ↓ -91% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $449.89 | ↓ -89% |
| Aetna | Medicare | $1,643.25 | ↓ -58% |
| Aetna | EBR ASO | $2,629.20 | ↓ -33% |
| Cigna | Commercial | $2,629.20 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,286.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $3,615.15 | ↓ -8% |
| InterGroup | PPO | $3,704.00 | ↓ -6% |
| Aetna | EBR FI | $3,812.34 | ↓ -3% |
| Aetna | Neighborhood Network | $3,943.80 | ↑ +0% |
| Aetna | Home Depot Employer Group | $4,055.54 | ↑ +3% |
| Aetna | NBR ASO/FI | $4,140.99 | ↑ +5% |
| Cigna | New Business ASO | $4,140.99 | ↑ +5% |
| Coventry/First Health | Commercial | $4,601.10 | ↑ +17% |
| Health Coalition Partners | PPO | $4,732.56 | ↑ +20% |
| UPMC Health Plan | Commercial | $5,013.23 | ↑ +27% |
| Private Health Care Systems | PPO | $5,258.40 | ↑ +33% |
| Humana | Commercial | $5,587.05 | ↑ +42% |
Visitor-reported prices
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Prcrd drg 6+yr without anomly at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,624.40 | $142.03 – $3,717.90 |
| UPMC Mercy | Pittsburgh | $2,783.40 | $140.69 – $4,175.10 |
| UPMC Presbyterian | Pittsburgh | $4,002.60 | $142.03 – $5,670.35 |
| UPMC Somerset | Somerset | $2,473.20 | $139.27 – $3,091.50 |