Cerv sr wire occ/man pre ots at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$227.40
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.
$379.00
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.
$75.80 with Highmark Wholecare (prev Gateway) vs $1,477.09 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $75.80 | ↓ -67% |
| Aetna | Medicare | $94.75 | ↓ -58% |
| Aetna | Neighborhood Network | $95.51 | ↓ -58% |
| Aetna | Home Depot Employer Group | $103.85 | ↓ -54% |
| Aetna | NBR ASO/FI | $106.12 | ↓ -53% |
| Cigna | New Business ASO | $106.12 | ↓ -53% |
| Aetna | EBR FI | $144.02 | ↓ -37% |
| Aetna | EBR ASO | $151.60 | ↓ -33% |
| Cigna | Commercial | $151.60 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $189.50 | ↓ -17% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $191.52 | ↓ -16% |
| PA Health & Wellness | PA Medicaid HMO | $208.45 | ↓ -8% |
| Coventry/First Health | Commercial | $265.30 | ↑ +17% |
| UPMC Work Partners | Workers Comp | $270.85 | ↑ +19% |
| Private Health Care Systems | PPO | $303.20 | ↑ +33% |
| SelectCare | Commercial | $303.20 | ↑ +33% |
| Humana | Commercial | $322.15 | ↑ +42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $551.48 | ↑ +143% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $554.31 | ↑ +144% |
| Highmark BCBS of PA | Managed Care | $738.55 | ↑ +225% |
| Highmark BCBS of PA | Commercial - Indemnity | $742.37 | ↑ +226% |
| UPMC Health Plan | Commercial | $866.85 | ↑ +281% |
| Highmark BCBS of PA | UPMC Emergent | $1,477.09 | ↑ +550% |
Visitor-reported prices
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Cerv sr wire occ/man pre ots at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $223.80 | $189.71 – $557.84 |
| UPMC Passavant-McCandless | Pittsburgh | $223.20 | $191.52 – $1,025.13 |
| UPMC East | Monroeville | $58.80 | $18.62 – $706.44 |
| UPMC Hamot | Erie | $1,200.60 | $189.71 – $270.85 |