healthcosts.net
Shunt glaucoma baerveldt 350mm at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$4,636.80
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.
?
What you pay up front if you don't use insurance.
$7,728.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1,257.60 with Highmark BCBS of PA vs $6,999.24 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 |
|---|---|---|---|
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,257.60 | ↓ -73% |
| Aetna | Medicare | $1,501.50 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,549.46 | ↓ -67% |
| PA Health & Wellness | PA Medicaid HMO | $1,981.98 | ↓ -57% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $2,031.83 | ↓ -56% |
| Aetna | EBR ASO | $2,402.40 | ↓ -48% |
| Cigna | Commercial | $2,402.40 | ↓ -48% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2,402.40 | ↓ -48% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,003.00 | ↓ -35% |
| Aetna | EBR FI | $3,483.48 | ↓ -25% |
| Aetna | Neighborhood Network | $3,603.60 | ↓ -22% |
| InterGroup | PPO | $3,704.00 | ↓ -20% |
| Aetna | Home Depot Employer Group | $3,705.70 | ↓ -20% |
| Aetna | NBR ASO/FI | $3,783.78 | ↓ -18% |
| Cigna | New Business ASO | $3,783.78 | ↓ -18% |
| Coventry/First Health | Commercial | $4,204.20 | ↓ -9% |
| Health Coalition Partners | PPO | $4,324.32 | ↓ -7% |
| Private Health Care Systems | PPO | $4,804.80 | ↑ +4% |
| Humana | Commercial | $5,105.10 | ↑ +10% |
| UPMC Health Plan | Commercial | $6,999.24 | ↑ +51% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Shunt glaucoma baerveldt 350mm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $5,882.40 | $484.55 – $4,567.35 |
| UPMC Muncy | Muncy | $5,572.20 | $343.35 – $2,060.10 |
| UPMC Passavant-McCandless | Pittsburgh | $5,235.60 | $489.17 – $8,393.41 |
| UPMC Presbyterian | Pittsburgh | $10,690.80 | $369.00 – $9,351.81 |
| UPMC St. Margaret | Pittsburgh | $4,636.80 | $489.17 – $7,097.47 |
| UPMC Wellsboro | Wellsboro | $6,739.20 | $491.94 – $2,459.70 |