healthcosts.net
Cath adherent clot 10mm 6f 10 at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$12,863.40
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.
$21,439.00
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.
$44.75 with Aetna vs $2,609.30 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 |
|---|---|---|---|
| Aetna | Medicare | $44.75 | ↓ -100% |
| Aetna | Neighborhood Network | $45.11 | ↓ -100% |
| Aetna | Home Depot Employer Group | $49.05 | ↓ -100% |
| Aetna | NBR ASO/FI | $50.12 | ↓ -100% |
| Cigna | New Business ASO | $50.12 | ↓ -100% |
| Aetna | EBR FI | $68.02 | ↓ -99% |
| Aetna | EBR ASO | $71.60 | ↓ -99% |
| Cigna | Commercial | $71.60 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $89.50 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $98.45 | ↓ -99% |
| Coventry/First Health | Commercial | $125.30 | ↓ -99% |
| Private Health Care Systems | PPO | $143.20 | ↓ -99% |
| SelectCare | Commercial | $143.20 | ↓ -99% |
| Humana | Commercial | $152.15 | ↓ -99% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $338.31 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $702.40 | ↓ -95% |
| Highmark BCBS of PA | Managed Care - Social Mission | $974.20 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $979.19 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1,188.11 | ↓ -91% |
| UPMC Health Plan | Commercial | $1,301.27 | ↓ -90% |
| Highmark BCBS of PA | Managed Care | $1,304.65 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,311.41 | ↓ -90% |
| Highmark BCBS of PA | UPMC Emergent | $2,609.30 | ↓ -80% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Cath adherent clot 10mm 6f 10 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $24,926.40 | $44.75 – $837.39 |
| UPMC Passavant-McCandless | Pittsburgh | $21,679.20 | $44.75 – $1,538.88 |
| UPMC Presbyterian | Pittsburgh | $33,235.80 | $2.52 – $1,714.59 |
| UPMC Northwest | Seneca | $1,504.20 | $5.75 – $1,283.27 |
| UPMC Somerset | Somerset | $4,761.60 | $64.19 – $635.18 |
| UPMC Williamsport | Williamsport | $15,737.40 | $5.94 – $19.80 |