healthcosts.net
Closed treatment of femoral fracture proximal end neck; wi at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$7,328.40
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.
$12,214.00
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.
$1,321.43 with Highmark BCBS of PA vs $10,381.90 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 | $1,321.43 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $1,985.86 | ↓ -73% |
| UPMC Health Plan | Commercial | $2,125.66 | ↓ -71% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,942.15 | ↓ -60% |
| Aetna | Medicare | $3,053.50 | ↓ -58% |
| Aetna | Neighborhood Network | $3,077.93 | ↓ -58% |
| Aetna | Home Depot Employer Group | $3,346.64 | ↓ -54% |
| Aetna | NBR ASO/FI | $3,419.92 | ↓ -53% |
| Cigna | New Business ASO | $3,419.92 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,824.65 | ↓ -48% |
| Highmark BCBS of PA | Managed Care | $3,940.35 | ↓ -46% |
| Aetna | EBR FI | $4,641.32 | ↓ -37% |
| Aetna | EBR ASO | $4,885.60 | ↓ -33% |
| Cigna | Commercial | $4,885.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,122.28 | ↓ -30% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,107.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $6,717.70 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $7,880.70 | ↑ +8% |
| Coventry/First Health | Commercial | $8,549.80 | ↑ +17% |
| Private Health Care Systems | PPO | $9,771.20 | ↑ +33% |
| SelectCare | Commercial | $9,771.20 | ↑ +33% |
| Humana | Commercial | $10,381.90 | ↑ +42% |
Visitor-reported prices
Comments
Closed treatment of femoral fracture proximal end neck; wi at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,279.60 | $1,308.97 – $4,919.40 |
| UPMC Presbyterian | Pittsburgh | $7,860.60 | $412.20 – $11,135.85 |
| UPMC Muncy | Muncy | $3,001.80 | $439.68 – $4,002.40 |
| UPMC Wellsboro | Wellsboro | $3,630.40 | $439.68 – $4,084.20 |
| UPMC Williamsport | Williamsport | $3,001.80 | $439.68 – $4,002.40 |