healthcosts.net
Athrectomy fem/pop/unilateral 37225 at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$35,730.60
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.
$59,551.00
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.
$11,817.71 with UPMC Health Plan vs $115,657.08 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 Health Plan | Commercial | $11,817.71 | ↓ -67% |
| UPMC Health Plan | Managed Medicare | $14,781.05 | ↓ -59% |
| Aetna | Neighborhood Network | $15,006.85 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $15,770.34 | ↓ -56% |
| Aetna | Home Depot Employer Group | $16,316.97 | ↓ -54% |
| Aetna | NBR ASO/FI | $16,674.28 | ↓ -53% |
| Cigna | New Business ASO | $16,674.28 | ↓ -53% |
| Aetna of PA | Medicare | $17,975.56 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,487.43 | ↓ -48% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,489.15 | ↓ -48% |
| Aetna | Medicare | $18,831.54 | ↓ -47% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $19,393.31 | ↓ -46% |
| Aetna | EBR FI | $22,629.38 | ↓ -37% |
| Aetna | EBR ASO | $23,820.40 | ↓ -33% |
| Cigna | Commercial | $23,820.40 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $32,753.05 | ↓ -8% |
| Coventry/First Health | Commercial | $41,685.70 | ↑ +17% |
| Highmark BCBS of PA | Managed Care - Social Mission | $43,178.92 | ↑ +21% |
| Private Health Care Systems | PPO | $47,640.80 | ↑ +33% |
| SelectCare | Commercial | $47,640.80 | ↑ +33% |
| Humana | Commercial | $50,618.35 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $56,130.53 | ↑ +57% |
| Highmark BCBS of PA | Managed Care | $57,828.54 | ↑ +62% |
| Highmark BCBS of PA | Commercial - Indemnity | $75,174.52 | ↑ +110% |
| Highmark BCBS of PA | UPMC Emergent | $115,657.08 | ↑ +224% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Athrectomy fem/pop/unilateral 37225 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $34,695.00 | $11,399.11 – $49,151.25 |
| UPMC Mercy | Pittsburgh | $34,849.20 | $571.49 – $52,273.80 |
| UPMC Presbyterian | Pittsburgh | $35,674.80 | $571.49 – $50,539.30 |
| UPMC Northwest | Seneca | $120,934.20 | $14,741.00 – $171,323.45 |
| UPMC Somerset | Somerset | $17,281.80 | $892.40 – $21,602.25 |
| UPMC Williamsport | Williamsport | $11,535.60 | $993.28 – $18,487.43 |