healthcosts.net
Stent iliac/open or perc/uni/init 37221 at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$21,381.00
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.
$35,635.00
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.
$3,704.00 with InterGroup vs $30,289.75 with Humana — 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 |
|---|---|---|---|
| InterGroup | PPO | $3,704.00 | ↓ -83% |
| UPMC Health Plan | Commercial | $5,385.45 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $6,886.55 | ↓ -68% |
| UPMC Health Plan | Managed Medicare | $9,805.28 | ↓ -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 | $10,811.87 | ↓ -49% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,069.19 | ↓ -48% |
| Aetna | Medicare | $11,136.23 | ↓ -48% |
| Aetna of PA | Medicare | $11,352.46 | ↓ -47% |
| United Healthcare | Unison Advantage Non Special Needs | $11,352.46 | ↓ -47% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,675.74 | ↓ -45% |
| AmeriHealth Caritas | Medicare | $11,676.82 | ↓ -45% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,676.82 | ↓ -45% |
| United Healthcare | Unison Advantage Special Needs | $11,893.06 | ↓ -44% |
| Aetna | EBR ASO | $14,254.00 | ↓ -33% |
| Cigna | Commercial | $14,254.00 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $19,599.25 | ↓ -8% |
| Aetna | EBR FI | $20,668.30 | ↓ -3% |
| Aetna | Neighborhood Network | $21,381.00 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $21,772.02 | ↑ +2% |
| Aetna | Home Depot Employer Group | $21,986.79 | ↑ +3% |
| Aetna | NBR ASO/FI | $22,450.05 | ↑ +5% |
| Cigna | New Business ASO | $22,450.05 | ↑ +5% |
| Coventry/First Health | Commercial | $24,944.50 | ↑ +17% |
| Health Coalition Partners | PPO | $25,657.20 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $26,824.76 | ↑ +25% |
| Private Health Care Systems | PPO | $28,508.00 | ↑ +33% |
| Humana | Commercial | $30,289.75 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Stent iliac/open or perc/uni/init 37221 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $33,589.20 | $5,152.97 – $47,584.70 |
| UPMC Mercy | Pittsburgh | $21,521.40 | $468.05 – $32,282.10 |
| UPMC Presbyterian | Pittsburgh | $32,172.60 | $468.05 – $45,577.85 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC St. Margaret | Pittsburgh | $17,448.00 | $5,116.53 – $24,718.00 |
| UPMC Williamsport | Williamsport | $6,724.80 | $993.28 – $11,675.74 |