healthcosts.net
Colonoscopy w/injection at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,449.20
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.
?
What you pay up front if you don't use insurance.
$4,082.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$177.89 with Highmark BCBS of PA vs $3,469.70 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $177.89 | ↓ -93% |
| Highmark BCBS of PA | Managed Care - Social Mission | $396.07 | ↓ -84% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $514.88 | ↓ -79% |
| Highmark BCBS of PA | Managed Care | $530.45 | ↓ -78% |
| Highmark BCBS of PA | Commercial - Indemnity | $689.57 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $970.56 | ↓ -60% |
| Aetna | Neighborhood Network | $1,028.66 | ↓ -58% |
| Highmark BCBS of PA | UPMC Emergent | $1,060.91 | ↓ -57% |
| Aetna | Home Depot Employer Group | $1,118.47 | ↓ -54% |
| Aetna | NBR ASO/FI | $1,142.96 | ↓ -53% |
| Cigna | New Business ASO | $1,142.96 | ↓ -53% |
| Aetna of PA | Medicare | $1,180.32 | ↓ -52% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,213.93 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,214.04 | ↓ -50% |
| Aetna | Medicare | $1,236.52 | ↓ -50% |
| Aetna | EBR FI | $1,551.16 | ↓ -37% |
| Aetna | EBR ASO | $1,632.80 | ↓ -33% |
| Cigna | Commercial | $1,632.80 | ↓ -33% |
| UPMC Health Plan | Commercial | $2,002.22 | ↓ -18% |
| PA Health & Wellness | PA Medicaid HMO | $2,245.10 | ↓ -8% |
| Coventry/First Health | Commercial | $2,857.40 | ↑ +17% |
| Private Health Care Systems | PPO | $3,265.60 | ↑ +33% |
| SelectCare | Commercial | $3,265.60 | ↑ +33% |
| Humana | Commercial | $3,469.70 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy w/injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,310.60 | $177.89 – $3,273.35 |
| UPMC Mercy | Pittsburgh | $2,595.60 | $176.21 – $3,893.40 |
| UPMC Presbyterian | Pittsburgh | $3,264.60 | $177.89 – $4,624.85 |
| UPMC Northwest | Seneca | $2,448.60 | $457.34 – $3,468.85 |
| UPMC Wellsboro | Wellsboro | $3,933.60 | $885.06 – $4,425.30 |
| UPMC Williamsport | Williamsport | $3,252.60 | $993.28 – $4,878.90 |