Foam drg >16<=48 sq in w/bdr at UPMC Magee
300 Halket Street, Pittsburgh, PA · UPMC · · NPI 1952311508
$18.60
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.
$31.00
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.
$4.68 with Aetna vs $97.45 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $4.68 | ↓ -75% |
| Aetna | Neighborhood Network | $9.36 | ↓ -50% |
| Aetna | EBR FI | $10.14 | ↓ -45% |
| Aetna | Home Depot Employer Group | $10.19 | ↓ -45% |
| Aetna | NBR ASO/FI | $10.40 | ↓ -44% |
| Aetna | EBR ASO | $10.40 | ↓ -44% |
| Cigna | Commercial | $10.40 | ↓ -44% |
| Cigna | New Business ASO | $10.40 | ↓ -44% |
| Aetna | Medicare | $10.76 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicare | $13.00 | ↓ -30% |
| InterGroup | PPO | $13.00 | ↓ -30% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $14.26 | ↓ -23% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $14.30 | ↓ -23% |
| Geisinger | Medicaid/CHIP | $14.30 | ↓ -23% |
| Coventry/First Health | Commercial | $18.20 | ↓ -2% |
| Preferred Healthcare System | PPO | $20.80 | ↑ +12% |
| Humana | Commercial | $22.10 | ↑ +19% |
| Private Health Care Systems | PPO | $22.10 | ↑ +19% |
| Multiplan | PPO | $23.92 | ↑ +29% |
| UPMC Health Plan | CHIP | $40.77 | ↑ +119% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $47.84 | ↑ +157% |
| Highmark BCBS of PA | Managed Care - Social Mission | $48.51 | ↑ +161% |
| UPMC Health Plan | Commercial | $62.98 | ↑ +239% |
| Highmark BCBS of PA | Commercial - Indemnity | $64.06 | ↑ +244% |
| Highmark BCBS of PA | Managed Care | $64.97 | ↑ +249% |
| Highmark BCBS of PA | UPMC Emergent | $97.45 | ↑ +424% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Foam drg >16<=48 sq in w/bdr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $25.20 | $14.26 – $59.16 |
| UPMC Presbyterian | Pittsburgh | $34.20 | $13.92 – $65.91 |
| UPMC St. Margaret | Pittsburgh | $19.80 | $14.26 – $50.03 |
| UPMC Altoona | Altoona | $10.20 | $8.50 – $40.77 |
| UPMC East | Monroeville | $19.80 | $7.75 – $40.77 |
| UPMC Hamot | Erie | $15.60 | $14.13 – $14.13 |
| UPMC Horizon-Greenville | Greenville | $13.80 | $36.00 – $40.77 |
| UPMC Jameson | New Castle | $12.00 | $9.78 – $40.77 |