healthcosts.net
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation at UPMC Northwest
100 Fairfield Drive, Seneca, PA · UPMC · · NPI 1619069440
$426.00
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.
$710.00
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.
$41.25 with UPMC Health Plan vs $603.50 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $41.25 | ↓ -90% |
| United Healthcare Community Plan for Families | Unison Kids | $43.12 | ↓ -90% |
| Aetna | Medicaid | $45.00 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $55.61 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $58.54 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $63.91 | ↓ -85% |
| UPMC Health Plan | Commercial | $120.03 | ↓ -72% |
| UPMC Work Partners | Workers Comp | $269.27 | ↓ -37% |
| Cigna | Commercial | $284.00 | ↓ -33% |
| Aetna | EBR ASO | $284.00 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $308.78 | ↓ -28% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $340.48 | ↓ -20% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $348.03 | ↓ -18% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $348.58 | ↓ -18% |
| Aetna | Medicare | $350.69 | ↓ -18% |
| United Healthcare | Unison Advantage Non Special Needs | $357.50 | ↓ -16% |
| Aetna of PA | Medicare | $357.50 | ↓ -16% |
| Highmark Wholecare (prev Gateway) | Medicare | $367.68 | ↓ -14% |
| AmeriHealth Caritas | Medicare | $367.72 | ↓ -14% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $367.72 | ↓ -14% |
| United Healthcare | Unison Advantage Special Needs | $374.53 | ↓ -12% |
| Aetna | EBR FI | $411.80 | ↓ -3% |
| Aetna | Neighborhood Network | $426.00 | ↑ +0% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $428.79 | ↑ +1% |
| Aetna | Home Depot Employer Group | $438.07 | ↑ +3% |
| Aetna | NBR ASO/FI | $447.30 | ↑ +5% |
| Cigna | New Business ASO | $447.30 | ↑ +5% |
| InterGroup | PPO | $461.50 | ↑ +8% |
| Coventry/First Health | Commercial | $497.00 | ↑ +17% |
| Health Coalition Partners | PPO | $511.20 | ↑ +20% |
| Private Health Care Systems | PPO | $568.00 | ↑ +33% |
| Humana | Commercial | $603.50 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,722.00 | $41.25 – $2,439.50 |
| UPMC Mercy | Pittsburgh | $1,868.40 | $41.25 – $2,802.60 |
| UPMC Muncy | Muncy | $723.60 | $28.80 – $964.80 |
| UPMC Presbyterian | Pittsburgh | $2,813.40 | $27.00 – $3,985.65 |
| UPMC Somerset | Somerset | $896.40 | $25.88 – $379.50 |
| UPMC St. Margaret | Pittsburgh | $1,668.60 | $41.25 – $2,363.85 |
| UPMC Wellsboro | Wellsboro | $875.20 | $28.80 – $984.60 |
| UPMC Williamsport | Williamsport | $723.60 | $28.80 – $964.80 |