healthcosts.net
Support clav 29.6-40.5in med at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$165.00
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.
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What you pay up front if you don't use insurance.
$275.00
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.
$68.75 with Aetna vs $362.95 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 | $68.75 | ↓ -58% |
| Aetna | EBR ASO | $110.00 | ↓ -33% |
| Cigna | Commercial | $110.00 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicaid | $110.00 | ↓ -33% |
| UPMC Work Partners | Workers Comp | $114.97 | ↓ -30% |
| Highmark Wholecare (prev Gateway) | Medicare | $137.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $151.25 | ↓ -8% |
| Aetna | EBR FI | $159.50 | ↓ -3% |
| Aetna | Neighborhood Network | $165.00 | ↑ +0% |
| Aetna | Home Depot Employer Group | $169.68 | ↑ +3% |
| Aetna | NBR ASO/FI | $173.25 | ↑ +5% |
| Cigna | New Business ASO | $173.25 | ↑ +5% |
| InterGroup | PPO | $178.75 | ↑ +8% |
| Coventry/First Health | Commercial | $192.50 | ↑ +17% |
| Health Coalition Partners | PPO | $198.00 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $209.09 | ↑ +27% |
| Private Health Care Systems | PPO | $220.00 | ↑ +33% |
| Humana | Commercial | $233.75 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $257.61 | ↑ +56% |
| UPMC Health Plan | Commercial | $362.95 | ↑ +120% |
Visitor-reported prices
Comments
Support clav 29.6-40.5in med at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $129.60 | $51.84 – $236.84 |
| UPMC Muncy | Muncy | $180.60 | $45.15 – $240.80 |
| UPMC Passavant-McCandless | Pittsburgh | $137.40 | $50.38 – $435.24 |
| UPMC Presbyterian | Pittsburgh | $133.20 | $26.64 – $484.94 |
| UPMC St. Margaret | Pittsburgh | $131.40 | $43.80 – $368.04 |
| UPMC Wellsboro | Wellsboro | $218.40 | $49.14 – $245.70 |
| UPMC Williamsport | Williamsport | $180.60 | $60.20 – $240.80 |