healthcosts.net
Cdna analysis for variants at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,008.20
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.
$3,347.00
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.
$159.90 with UPMC Health Plan vs $2,155.34 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicare | $159.90 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $183.04 | ↓ -91% |
| Aetna of PA | Medicare | $194.46 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $200.00 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $200.02 | ↓ -90% |
| Aetna | Medicare | $203.72 | ↓ -90% |
| Aetna | Neighborhood Network | $252.00 | ↓ -87% |
| UPMC Health Plan | Commercial | $272.09 | ↓ -86% |
| Aetna | Home Depot Employer Group | $274.00 | ↓ -86% |
| Aetna | NBR ASO/FI | $280.00 | ↓ -86% |
| Cigna | New Business ASO | $280.00 | ↓ -86% |
| Aetna | EBR FI | $380.00 | ↓ -81% |
| Aetna | EBR ASO | $400.00 | ↓ -80% |
| Cigna | Commercial | $400.00 | ↓ -80% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $462.90 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $550.00 | ↓ -73% |
| Coventry/First Health | Commercial | $700.00 | ↓ -65% |
| Private Health Care Systems | PPO | $800.00 | ↓ -60% |
| SelectCare | Commercial | $800.00 | ↓ -60% |
| Highmark BCBS of PA | Managed Care - Social Mission | $804.67 | ↓ -60% |
| Humana | Commercial | $850.00 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $1,077.67 | ↓ -46% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,339.77 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,794.33 | ↓ -11% |
| Highmark BCBS of PA | UPMC Emergent | $2,155.34 | ↑ +7% |
Visitor-reported prices
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Cdna analysis for variants at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,118.00 | $141.78 – $462.90 |
| UPMC Mercy | Pittsburgh | $2,009.40 | $154.38 – $916.20 |
| UPMC Presbyterian | Pittsburgh | $2,009.40 | $70.74 – $462.90 |
| UPMC Muncy | Muncy | $1,792.80 | $144.60 – $948.00 |
| UPMC Northwest | Seneca | $7,041.00 | $167.96 – $486.20 |
| UPMC Somerset | Somerset | $1,070.40 | $129.92 – $1,338.00 |
| UPMC Wellsboro | Wellsboro | $2,276.80 | $96.12 – $480.60 |
| UPMC Williamsport | Williamsport | $1,934.40 | $144.60 – $633.60 |