healthcosts.net
App high cost ss t/a/l >100sq cm 1st 100sq cm at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,326.20
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.
$3,877.00
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.
$420.87 with UPMC Work Partners vs $4,712.31 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 | $420.87 | ↓ -82% |
| UPMC Health Plan | Commercial | $462.80 | ↓ -80% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $790.16 | ↓ -66% |
| Aetna | Medicare | $968.50 | ↓ -58% |
| Aetna | Neighborhood Network | $976.25 | ↓ -58% |
| Aetna | Home Depot Employer Group | $1,061.48 | ↓ -54% |
| Aetna | NBR ASO/FI | $1,084.72 | ↓ -53% |
| Cigna | New Business ASO | $1,084.72 | ↓ -53% |
| Aetna | EBR FI | $1,472.12 | ↓ -37% |
| Aetna | EBR ASO | $1,549.60 | ↓ -33% |
| Cigna | Commercial | $1,549.60 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,759.27 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,937.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $2,130.70 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,286.97 | ↓ -2% |
| Highmark BCBS of PA | Managed Care | $2,356.15 | ↑ +1% |
| Coventry/First Health | Commercial | $2,711.80 | ↑ +17% |
| UPMC Health Plan | Managed Medicare | $3,013.53 | ↑ +30% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,062.89 | ↑ +32% |
| Private Health Care Systems | PPO | $3,099.20 | ↑ +33% |
| SelectCare | Commercial | $3,099.20 | ↑ +33% |
| Humana | Commercial | $3,292.90 | ↑ +42% |
| Aetna of PA | Medicare | $3,664.82 | ↑ +58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,769.52 | ↑ +62% |
| Highmark BCBS of PA | UPMC Emergent | $4,712.31 | ↑ +103% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
App high cost ss t/a/l >100sq cm 1st 100sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,154.80 | $420.87 – $4,469.30 |
| UPMC Presbyterian | Pittsburgh | $5,403.00 | $392.31 – $7,654.25 |
| UPMC Mercy | Pittsburgh | not published | $472.54 – $3,839.33 |
| UPMC Wellsboro | Wellsboro | $6,088.00 | $98.64 – $993.28 |
| UPMC Williamsport | Williamsport | $5,034.60 | $420.87 – $6,712.80 |