healthcosts.net
St treatment swallow dysfunction/oral at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$130.20
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.
$217.00
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.
$54.25 with Aetna vs $460.77 with Highmark BCBS of PA — 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 | $54.25 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $84.21 | ↓ -35% |
| Aetna | EBR ASO | $86.80 | ↓ -33% |
| Cigna | Commercial | $86.80 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $108.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $119.35 | ↓ -8% |
| Aetna | EBR FI | $125.86 | ↓ -3% |
| Aetna | Neighborhood Network | $130.20 | ↑ +0% |
| Aetna | Home Depot Employer Group | $133.89 | ↑ +3% |
| Aetna | NBR ASO/FI | $136.71 | ↑ +5% |
| Cigna | New Business ASO | $136.71 | ↑ +5% |
| InterGroup | PPO | $141.05 | ↑ +8% |
| Coventry/First Health | Commercial | $151.90 | ↑ +17% |
| Health Coalition Partners | PPO | $156.24 | ↑ +20% |
| Private Health Care Systems | PPO | $173.60 | ↑ +33% |
| Humana | Commercial | $184.45 | ↑ +42% |
| UPMC Health Plan | Commercial | $317.89 | ↑ +144% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $373.98 | ↑ +187% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $460.77 | ↑ +254% |
Visitor-reported prices
Comments
St treatment swallow dysfunction/oral at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $146.40 | $61.00 – $219.60 |
| UPMC Muncy | Muncy | $179.40 | $44.85 – $239.20 |
| UPMC Passavant-McCandless | Pittsburgh | $362.40 | $89.57 – $513.40 |
| UPMC Presbyterian | Pittsburgh | $335.40 | $57.29 – $475.15 |
| UPMC Somerset | Somerset | $384.60 | $54.90 – $253.50 |
| UPMC St. Margaret | Pittsburgh | $318.00 | $89.57 – $450.50 |
| UPMC Wellsboro | Wellsboro | $216.80 | $48.78 – $243.90 |
| UPMC Williamsport | Williamsport | $179.40 | $61.11 – $239.20 |