healthcosts.net
Stent bili dbl pgtl 10fx5cm at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$712.20
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.
$1,187.00
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.
$49.50 with Aetna vs $1,042.23 with UPMC Health Plan — 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 | $49.50 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $65.34 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $66.98 | ↓ -91% |
| Aetna | EBR ASO | $79.20 | ↓ -89% |
| Cigna | Commercial | $79.20 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $79.20 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicare | $99.00 | ↓ -86% |
| Aetna | EBR FI | $114.84 | ↓ -84% |
| Aetna | Neighborhood Network | $118.80 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $118.80 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $118.80 | ↓ -83% |
| Aetna | Home Depot Employer Group | $122.17 | ↓ -83% |
| Aetna | NBR ASO/FI | $124.74 | ↓ -82% |
| Cigna | New Business ASO | $124.74 | ↓ -82% |
| InterGroup | PPO | $128.70 | ↓ -82% |
| Coventry/First Health | Commercial | $138.60 | ↓ -81% |
| Health Coalition Partners | PPO | $142.56 | ↓ -80% |
| Private Health Care Systems | PPO | $158.40 | ↓ -78% |
| Humana | Commercial | $168.30 | ↓ -76% |
| UPMC Health Plan | Commercial | $1,042.23 | ↑ +46% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Stent bili dbl pgtl 10fx5cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $720.00 | $29.04 – $680.10 |
| UPMC Muncy | Muncy | $477.60 | $29.70 – $178.20 |
| UPMC Passavant-McCandless | Pittsburgh | $810.00 | $33.44 – $1,249.82 |
| UPMC Presbyterian | Pittsburgh | $3,092.40 | $14.52 – $1,392.54 |
| UPMC Somerset | Somerset | $361.20 | $80.60 – $515.88 |
| UPMC St. Margaret | Pittsburgh | $1,015.20 | $28.00 – $1,056.85 |
| UPMC Wellsboro | Wellsboro | $577.60 | $32.58 – $162.90 |
| UPMC Williamsport | Williamsport | $1,894.80 | $22.20 – $99.90 |