healthcosts.net
Abd/low ext cath 1st at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$1,860.60
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.
$3,101.00
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.
$763.10 with UPMC Work Partners vs $5,038.97 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 Work Partners | Workers Comp | $763.10 | ↓ -59% |
| Aetna | Medicare | $775.25 | ↓ -58% |
| Aetna | Neighborhood Network | $781.45 | ↓ -58% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $844.93 | ↓ -55% |
| Aetna | Home Depot Employer Group | $849.67 | ↓ -54% |
| Aetna | NBR ASO/FI | $868.28 | ↓ -53% |
| Cigna | New Business ASO | $868.28 | ↓ -53% |
| Aetna | EBR FI | $1,178.38 | ↓ -37% |
| Aetna | EBR ASO | $1,240.40 | ↓ -33% |
| Cigna | Commercial | $1,240.40 | ↓ -33% |
| UPMC Health Plan | Commercial | $1,534.63 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,550.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $1,705.55 | ↓ -8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,881.23 | ↑ +1% |
| Coventry/First Health | Commercial | $2,170.70 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,445.51 | ↑ +31% |
| Private Health Care Systems | PPO | $2,480.80 | ↑ +33% |
| SelectCare | Commercial | $2,480.80 | ↑ +33% |
| Highmark BCBS of PA | Managed Care | $2,519.49 | ↑ +35% |
| Humana | Commercial | $2,635.85 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,275.22 | ↑ +76% |
| Highmark BCBS of PA | UPMC Emergent | $5,038.97 | ↑ +171% |
Visitor-reported prices
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Abd/low ext cath 1st at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,540.80 | $763.10 – $6,432.80 |
| UPMC Mercy | Pittsburgh | $4,752.00 | $771.90 – $7,128.00 |
| UPMC Presbyterian | Pittsburgh | $5,849.40 | $771.90 – $8,286.65 |
| UPMC Northwest | Seneca | $5,015.40 | $726.45 – $7,105.15 |
| UPMC Somerset | Somerset | $4,321.20 | $717.91 – $5,401.50 |
| UPMC Williamsport | Williamsport | $1,138.20 | $512.19 – $1,517.60 |