healthcosts.net
Cath council tip 16fr 5cc at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$32.40
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.
$54.00
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.
$2.50 with Aetna vs $93.45 with UPMC Health Plan — 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 | $2.50 | ↓ -92% |
| Aetna | Neighborhood Network | $2.52 | ↓ -92% |
| Aetna | Home Depot Employer Group | $2.74 | ↓ -92% |
| Aetna | NBR ASO/FI | $2.80 | ↓ -91% |
| Cigna | New Business ASO | $2.80 | ↓ -91% |
| Aetna | EBR FI | $3.80 | ↓ -88% |
| Aetna | EBR ASO | $4.00 | ↓ -88% |
| Cigna | Commercial | $4.00 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $5.00 | ↓ -85% |
| PA Health & Wellness | PA Medicaid HMO | $5.50 | ↓ -83% |
| Highmark BCBS of PA | Managed Care | $5.60 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $5.60 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity | $5.70 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5.70 | ↓ -82% |
| Coventry/First Health | Commercial | $7.00 | ↓ -78% |
| Private Health Care Systems | PPO | $8.00 | ↓ -75% |
| SelectCare | Commercial | $8.00 | ↓ -75% |
| Humana | Commercial | $8.50 | ↓ -74% |
| Highmark BCBS of PA | UPMC Emergent | $11.20 | ↓ -65% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $22.46 | ↓ -31% |
| UPMC Work Partners | Workers Comp | $31.77 | ↓ -2% |
| UPMC Health Plan | Commercial | $93.45 | ↑ +188% |
Visitor-reported prices
Comments
Cath council tip 16fr 5cc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $75.00 | $2.00 – $60.14 |
| UPMC Passavant-McCandless | Pittsburgh | $71.40 | $2.25 – $110.52 |
| UPMC Presbyterian | Pittsburgh | $496.20 | $1.98 – $123.14 |
| UPMC Muncy | Muncy | $45.60 | $2.25 – $31.77 |
| UPMC Northwest | Seneca | $130.20 | $2.00 – $92.16 |
| UPMC Wellsboro | Wellsboro | $57.60 | $1.71 – $31.77 |
| UPMC Williamsport | Williamsport | $42.00 | $2.70 – $31.77 |