healthcosts.net
2d tee w or without fol w/con,in at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,589.00
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.
$4,315.00
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.
$436.57 with Highmark BCBS of PA vs $3,667.75 with Humana — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $436.57 | ↓ -83% |
| UPMC Health Plan | Managed Medicare | $650.34 | ↓ -75% |
| Aetna of PA | Medicare | $790.89 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $813.41 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $813.49 | ↓ -69% |
| Aetna | Medicare | $828.55 | ↓ -68% |
| Aetna | Neighborhood Network | $1,087.38 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,140.33 | ↓ -56% |
| Aetna | Home Depot Employer Group | $1,182.31 | ↓ -54% |
| Aetna | NBR ASO/FI | $1,208.20 | ↓ -53% |
| Cigna | New Business ASO | $1,208.20 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,263.57 | ↓ -51% |
| Highmark BCBS of PA | Managed Care | $1,527.25 | ↓ -41% |
| Aetna | EBR FI | $1,639.70 | ↓ -37% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,692.27 | ↓ -35% |
| Aetna | EBR ASO | $1,726.00 | ↓ -33% |
| Cigna | Commercial | $1,726.00 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $2,373.25 | ↓ -8% |
| Coventry/First Health | Commercial | $3,020.50 | ↑ +17% |
| UPMC Health Plan | Commercial | $3,021.24 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $3,054.51 | ↑ +18% |
| Private Health Care Systems | PPO | $3,452.00 | ↑ +33% |
| SelectCare | Commercial | $3,452.00 | ↑ +33% |
| Humana | Commercial | $3,667.75 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
2d tee w or without fol w/con,in at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $2,358.00 | $432.45 – $3,537.00 |
| UPMC Passavant-McCandless | Pittsburgh | $4,258.80 | $436.57 – $6,033.30 |
| UPMC Presbyterian | Pittsburgh | $4,141.20 | $436.57 – $5,866.70 |
| UPMC Muncy | Muncy | $848.40 | $212.10 – $1,272.60 |
| UPMC Northwest | Seneca | $1,641.60 | $683.10 – $2,325.60 |
| UPMC Somerset | Somerset | $1,450.80 | $428.08 – $1,813.50 |
| UPMC Wellsboro | Wellsboro | $1,026.40 | $230.94 – $1,154.70 |
| UPMC Williamsport | Williamsport | $848.40 | $562.63 – $1,272.60 |