healthcosts.net
Cath plc art/angio/rt hrt cath at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$19,438.80
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.
$32,398.00
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.
$1,363.65 with Highmark BCBS of PA vs $27,538.30 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 | $1,363.65 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $1,622.87 | ↓ -92% |
| UPMC Health Plan | Managed Medicare | $2,647.58 | ↓ -86% |
| Aetna of PA | Medicare | $3,219.78 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,311.47 | ↓ -83% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,311.78 | ↓ -83% |
| Aetna | Medicare | $3,373.11 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,561.92 | ↓ -82% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,946.85 | ↓ -80% |
| Highmark BCBS of PA | Managed Care | $4,770.49 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,285.94 | ↓ -73% |
| Aetna | Neighborhood Network | $8,164.30 | ↓ -58% |
| UPMC Health Plan | Commercial | $8,452.00 | ↓ -57% |
| Aetna | Home Depot Employer Group | $8,877.05 | ↓ -54% |
| Aetna | NBR ASO/FI | $9,071.44 | ↓ -53% |
| Cigna | New Business ASO | $9,071.44 | ↓ -53% |
| Highmark BCBS of PA | UPMC Emergent | $9,540.99 | ↓ -51% |
| Aetna | EBR FI | $12,311.24 | ↓ -37% |
| Aetna | EBR ASO | $12,959.20 | ↓ -33% |
| Cigna | Commercial | $12,959.20 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $17,818.90 | ↓ -8% |
| Coventry/First Health | Commercial | $22,678.60 | ↑ +17% |
| Private Health Care Systems | PPO | $25,918.40 | ↑ +33% |
| SelectCare | Commercial | $25,918.40 | ↑ +33% |
| Humana | Commercial | $27,538.30 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Cath plc art/angio/rt hrt cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $12,175.20 | $1,350.79 – $18,262.80 |
| UPMC Passavant-McCandless | Pittsburgh | $15,848.40 | $1,363.65 – $22,451.90 |
| UPMC Presbyterian | Pittsburgh | $16,701.60 | $931.20 – $23,660.60 |
| UPMC Northwest | Seneca | $8,503.80 | $1,622.87 – $12,047.05 |
| UPMC Somerset | Somerset | $5,873.40 | $892.40 – $7,341.75 |
| UPMC Williamsport | Williamsport | $7,321.20 | $993.28 – $9,761.60 |