healthcosts.net
Brach/thor cath 2nd at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$5,364.60
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.
?
What you pay up front if you don't use insurance.
$8,941.00
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.
$125.95 with UPMC Health Plan vs $9,822.12 with Highmark BCBS of PA — 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 Medicaid | $125.95 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $125.95 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $169.80 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $178.75 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $195.13 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $795.09 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,646.97 | ↓ -69% |
| Aetna | Medicare | $2,235.25 | ↓ -58% |
| Aetna | Neighborhood Network | $2,253.13 | ↓ -58% |
| Aetna | Home Depot Employer Group | $2,449.83 | ↓ -54% |
| Aetna | NBR ASO/FI | $2,503.48 | ↓ -53% |
| Cigna | New Business ASO | $2,503.48 | ↓ -53% |
| UPMC Health Plan | Commercial | $2,986.38 | ↓ -44% |
| Aetna | EBR FI | $3,397.58 | ↓ -37% |
| Aetna | EBR ASO | $3,576.40 | ↓ -33% |
| Cigna | Commercial | $3,576.40 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,666.95 | ↓ -32% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,470.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,766.86 | ↓ -11% |
| Highmark BCBS of PA | Managed Care | $4,911.06 | ↓ -8% |
| Coventry/First Health | Commercial | $6,258.70 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,384.16 | ↑ +19% |
| Private Health Care Systems | PPO | $7,152.80 | ↑ +33% |
| SelectCare | Commercial | $7,152.80 | ↑ +33% |
| Humana | Commercial | $7,599.85 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $9,822.12 | ↑ +83% |
Visitor-reported prices
Comments
Brach/thor cath 2nd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $8,350.20 | $125.95 – $11,829.45 |
| UPMC Mercy | Pittsburgh | $5,967.60 | $125.95 – $8,951.40 |
| UPMC Presbyterian | Pittsburgh | $15,733.20 | $125.95 – $22,288.70 |
| UPMC Northwest | Seneca | $10,167.00 | $125.95 – $14,403.25 |
| UPMC Somerset | Somerset | $2,881.20 | $125.95 – $3,601.50 |
| UPMC Williamsport | Williamsport | $947.40 | $125.95 – $1,263.20 |