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Carotid Artery Ultrasound (Duplex) at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$1,033.80
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.
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What you pay up front if you don't use insurance.
$1,723.00
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.
$162.09 with Highmark BCBS of PA vs $1,464.55 with Humana — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $162.09 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $162.65 | ↓ -84% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $162.65 | ↓ -84% |
| UPMC Health Plan | Managed Medicare | $198.97 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $219.28 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $230.82 | ↓ -78% |
| Aetna of PA | Medicare | $241.97 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicare | $248.86 | ↓ -76% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $248.89 | ↓ -76% |
| PA Health & Wellness | PA Medicaid HMO | $251.98 | ↓ -76% |
| Aetna | Medicare | $253.50 | ↓ -75% |
| Highmark BCBS of PA | Managed Care - Social Mission | $423.39 | ↓ -59% |
| Aetna | Neighborhood Network | $434.20 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $469.15 | ↓ -55% |
| Aetna | Home Depot Employer Group | $472.10 | ↓ -54% |
| Aetna | NBR ASO/FI | $482.44 | ↓ -53% |
| Cigna | New Business ASO | $482.44 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $567.05 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $575.42 | ↓ -44% |
| UPMC Health Plan | Commercial | $618.86 | ↓ -40% |
| Highmark BCBS of PA | Commercial - Indemnity | $628.32 | ↓ -39% |
| Aetna | EBR FI | $654.74 | ↓ -37% |
| Aetna | EBR ASO | $689.20 | ↓ -33% |
| Cigna | Commercial | $689.20 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $1,134.10 | ↑ +10% |
| Coventry/First Health | Commercial | $1,206.10 | ↑ +17% |
| Private Health Care Systems | PPO | $1,378.40 | ↑ +33% |
| SelectCare | Commercial | $1,378.40 | ↑ +33% |
| Humana | Commercial | $1,464.55 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Carotid Artery Ultrasound (Duplex) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,764.20 | $162.09 – $3,915.95 |
| UPMC Magee | Pittsburgh | $507.60 | $162.09 – $778.32 |
| UPMC Mercy | Pittsburgh | $1,441.80 | $160.56 – $2,162.70 |
| UPMC Presbyterian | Pittsburgh | $2,251.20 | $143.21 – $3,189.20 |
| UPMC East | Monroeville | $831.00 | $162.09 – $1,108.00 |
| UPMC Hamot | Erie | $1,007.40 | $94.90 – $1,175.30 |
| UPMC Lititz | Lititz | $788.40 | $156.34 – $1,116.90 |
| UPMC Carlisle | Carlisle | $788.40 | $156.34 – $1,116.90 |