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Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
not published by hospital
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.
not published by hospital
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.
$268.40 with UPMC Health Plan vs $2,676.36 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $268.40 | — |
| United Healthcare Community Plan for Families | Unison Kids | $280.60 | — |
| Aetna | Medicaid | $292.80 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $361.85 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $380.91 | — |
| PA Health & Wellness | PA Medicaid HMO | $415.82 | — |
| UPMC Health Plan | Commercial | $1,246.46 | — |
| UPMC Health Plan | Managed Medicare | $1,581.59 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,743.95 | — |
| UPMC Work Partners | Workers Comp | $1,782.73 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,785.46 | — |
| Aetna | Medicare | $1,796.27 | — |
| Aetna of PA | Medicare | $1,831.15 | — |
| United Healthcare | Unison Advantage Non Special Needs | $1,831.15 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $1,883.29 | — |
| AmeriHealth Caritas | Medicare | $1,883.47 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,883.47 | — |
| United Healthcare | Unison Advantage Special Needs | $1,918.35 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,172.24 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,676.36 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Trnsfr/rearrngmnt adjcnt tiss e/n/e/l dfct 10sqcm/< at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $5,214.00 | $268.40 – $7,386.50 |
| UPMC St. Margaret | Pittsburgh | $3,955.80 | $268.40 – $5,604.05 |
| UPMC Williamsport | Williamsport | $5,275.20 | $268.40 – $7,033.60 |
| UPMC Mercy | Pittsburgh | not published | $268.40 – $1,918.35 |
| UPMC Somerset | Somerset | not published | $268.40 – $1,743.95 |
| UPMC Wellsboro | Wellsboro | not published | $268.40 – $1,730.23 |