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Stent/athrectomy/fem/pop/unilat 37227 at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$54,766.80
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.
$91,278.00
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.
$3,704.00 with InterGroup vs $83,022.20 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 |
|---|---|---|---|
| InterGroup | PPO | $3,704.00 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $15,525.75 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $17,119.58 | ↓ -69% |
| UPMC Health Plan | Commercial | $17,255.82 | ↓ -68% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $17,527.03 | ↓ -68% |
| Aetna | Medicare | $17,633.17 | ↓ -68% |
| Aetna of PA | Medicare | $17,975.56 | ↓ -67% |
| United Healthcare | Unison Advantage Non Special Needs | $17,975.56 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,487.43 | ↓ -66% |
| AmeriHealth Caritas | Medicare | $18,489.15 | ↓ -66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,489.15 | ↓ -66% |
| United Healthcare | Unison Advantage Special Needs | $18,831.54 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $21,313.78 | ↓ -61% |
| Aetna | EBR ASO | $36,511.20 | ↓ -33% |
| Cigna | Commercial | $36,511.20 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $50,202.90 | ↓ -8% |
| Aetna | EBR FI | $52,941.24 | ↓ -3% |
| Aetna | Neighborhood Network | $54,766.80 | ↑ +0% |
| Aetna | Home Depot Employer Group | $56,318.53 | ↑ +3% |
| Aetna | NBR ASO/FI | $57,505.14 | ↑ +5% |
| Cigna | New Business ASO | $57,505.14 | ↑ +5% |
| Coventry/First Health | Commercial | $63,894.60 | ↑ +17% |
| Health Coalition Partners | PPO | $65,720.16 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $67,384.04 | ↑ +23% |
| Private Health Care Systems | PPO | $73,022.40 | ↑ +33% |
| Humana | Commercial | $77,586.30 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $83,022.20 | ↑ +52% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Stent/athrectomy/fem/pop/unilat 37227 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $67,511.40 | $13,343.80 – $95,641.15 |
| UPMC Mercy | Pittsburgh | $60,352.80 | $690.34 – $90,529.20 |
| UPMC Presbyterian | Pittsburgh | $55,112.40 | $690.34 – $78,075.90 |
| UPMC Somerset | Somerset | $24,161.40 | $892.40 – $30,201.75 |
| UPMC St. Margaret | Pittsburgh | $61,878.60 | $13,833.82 – $87,661.35 |
| UPMC Williamsport | Williamsport | $15,054.60 | $993.28 – $22,581.90 |