healthcosts.net
Aspa gene at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$1,108.20
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.
?
What you pay up front if you don't use insurance.
$1,847.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$40.80 with UPMC Health Plan vs $1,569.95 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 Health Plan | Managed Medicare | $40.80 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $46.70 | ↓ -96% |
| Aetna of PA | Medicare | $49.61 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicare | $51.03 | ↓ -95% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $51.03 | ↓ -95% |
| Aetna | Medicare | $51.98 | ↓ -95% |
| UPMC Health Plan | Commercial | $55.59 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $138.07 | ↓ -88% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $138.07 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $186.15 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $195.95 | ↓ -82% |
| PA Health & Wellness | PA Medicaid HMO | $213.91 | ↓ -81% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $274.83 | ↓ -75% |
| Aetna | Neighborhood Network | $465.44 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $477.75 | ↓ -57% |
| Aetna | Home Depot Employer Group | $506.08 | ↓ -54% |
| Aetna | NBR ASO/FI | $517.16 | ↓ -53% |
| Cigna | New Business ASO | $517.16 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $639.84 | ↓ -42% |
| Aetna | EBR FI | $701.86 | ↓ -37% |
| Aetna | EBR ASO | $738.80 | ↓ -33% |
| Cigna | Commercial | $738.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $795.45 | ↓ -28% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,065.34 | ↓ -4% |
| Highmark BCBS of PA | UPMC Emergent | $1,279.68 | ↑ +15% |
| Coventry/First Health | Commercial | $1,292.90 | ↑ +17% |
| Private Health Care Systems | PPO | $1,477.60 | ↑ +33% |
| SelectCare | Commercial | $1,477.60 | ↑ +33% |
| Humana | Commercial | $1,569.95 | ↑ +42% |
Visitor-reported prices
Comments
Aspa gene at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,108.20 | $43.91 – $1,569.95 |
| UPMC Presbyterian | Pittsburgh | $1,108.20 | $46.70 – $1,569.95 |