healthcosts.net
Removal/replacement ppm generator dual lead system 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.
$518.50 with UPMC Work Partners vs $18,908.60 with UPMC Health Plan — 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 Work Partners | Workers Comp | $518.50 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,162.56 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,432.36 | — |
| UPMC Health Plan | Managed Medicare | $9,048.54 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $9,977.44 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10,214.90 | — |
| Aetna | Medicare | $10,276.76 | — |
| Aetna of PA | Medicare | $10,476.31 | — |
| United Healthcare | Unison Advantage Non Special Needs | $10,476.31 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $10,774.64 | — |
| AmeriHealth Caritas | Medicare | $10,775.64 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,775.64 | — |
| United Healthcare | Unison Advantage Special Needs | $10,975.18 | — |
| UPMC Health Plan | Commercial | $18,908.60 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Removal/replacement ppm generator dual lead system at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $33,155.40 | $452.20 – $46,970.15 |
| UPMC Mercy | Pittsburgh | $29,639.40 | $447.93 – $44,459.10 |
| UPMC Presbyterian | Pittsburgh | $40,853.40 | $452.20 – $57,875.65 |
| UPMC Somerset | Somerset | $19,161.00 | $443.40 – $23,951.25 |
| UPMC Williamsport | Williamsport | $5,997.00 | $518.50 – $10,774.64 |