healthcosts.net
Bx vulva or perineum/1 lesion 56605 at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,812.80
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.
$4,688.00
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.
$61.06 with UPMC Health Plan vs $3,984.80 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 Medicaid | $61.06 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $61.06 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $82.32 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $86.66 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $94.60 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $275.11 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $550.23 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $716.75 | ↓ -75% |
| UPMC Health Plan | Commercial | $777.19 | ↓ -72% |
| Aetna of PA | Medicare | $871.66 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $896.48 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $896.56 | ↓ -68% |
| Aetna | Medicare | $913.16 | ↓ -68% |
| Aetna | Neighborhood Network | $1,181.38 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,225.07 | ↓ -56% |
| Aetna | Home Depot Employer Group | $1,284.51 | ↓ -54% |
| Aetna | NBR ASO/FI | $1,312.64 | ↓ -53% |
| Cigna | New Business ASO | $1,312.64 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,592.54 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $1,640.71 | ↓ -42% |
| Aetna | EBR FI | $1,781.44 | ↓ -37% |
| Aetna | EBR ASO | $1,875.20 | ↓ -33% |
| Cigna | Commercial | $1,875.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,132.85 | ↓ -24% |
| Highmark BCBS of PA | UPMC Emergent | $3,281.43 | ↑ +17% |
| Coventry/First Health | Commercial | $3,281.60 | ↑ +17% |
| Private Health Care Systems | PPO | $3,750.40 | ↑ +33% |
| SelectCare | Commercial | $3,750.40 | ↑ +33% |
| Humana | Commercial | $3,984.80 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Bx vulva or perineum/1 lesion 56605 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,544.20 | $61.06 – $5,020.95 |
| UPMC Presbyterian | Pittsburgh | $3,063.60 | $61.06 – $4,340.10 |
| UPMC Somerset | Somerset | $1,452.00 | $61.06 – $1,815.00 |
| UPMC Wellsboro | Wellsboro | $4,291.20 | $31.86 – $993.28 |
| UPMC Williamsport | Williamsport | $489.60 | $61.06 – $993.28 |