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Allograft dermis 20x25x1mm decell w/matracell arthroflex at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$12,411.00
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.
$20,685.00
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.
$668.60 with Highmark Wholecare (prev Gateway) vs $3,744.16 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $668.60 | ↓ -95% |
| Aetna | Medicare | $835.75 | ↓ -93% |
| Aetna | Neighborhood Network | $842.44 | ↓ -93% |
| Aetna | Home Depot Employer Group | $915.98 | ↓ -93% |
| Aetna | NBR ASO/FI | $936.04 | ↓ -92% |
| Cigna | New Business ASO | $936.04 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $1,103.19 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,130.94 | ↓ -91% |
| Aetna | EBR FI | $1,270.34 | ↓ -90% |
| Aetna | EBR ASO | $1,337.20 | ↓ -89% |
| Cigna | Commercial | $1,337.20 | ↓ -89% |
| UPMC Health Plan | Commercial | $1,639.74 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,671.50 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,671.50 | ↓ -87% |
| Highmark BCBS of PA | Managed Care | $1,872.08 | ↓ -85% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,872.08 | ↓ -85% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,905.51 | ↓ -85% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,905.51 | ↓ -85% |
| Coventry/First Health | Commercial | $2,340.10 | ↓ -81% |
| Private Health Care Systems | PPO | $2,674.40 | ↓ -78% |
| SelectCare | Commercial | $2,674.40 | ↓ -78% |
| Humana | Commercial | $2,841.55 | ↓ -77% |
| Highmark BCBS of PA | UPMC Emergent | $3,744.16 | ↓ -70% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Allograft dermis 20x25x1mm decell w/matracell arthroflex at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $12,411.00 | $821.48 – $3,173.90 |
| UPMC Presbyterian | Pittsburgh | $16,546.20 | $567.00 – $4,016.25 |
| UPMC Muncy | Muncy | $2,027.40 | $506.85 – $3,041.10 |
| UPMC Wellsboro | Wellsboro | $5,792.80 | $1,303.38 – $6,516.90 |
| UPMC Williamsport | Williamsport | $9,287.40 | $613.00 – $2,758.50 |