Composite drsg <= 16 sq in at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$3.60
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.
$6.00
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.
$1.25 with Aetna vs $46.17 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 |
|---|---|---|---|
| Aetna | Medicare | $1.25 | ↓ -65% |
| Aetna | Neighborhood Network | $1.26 | ↓ -65% |
| Aetna | Home Depot Employer Group | $1.37 | ↓ -62% |
| Cigna | New Business ASO | $1.40 | ↓ -61% |
| Aetna | NBR ASO/FI | $1.40 | ↓ -61% |
| Aetna | EBR FI | $1.90 | ↓ -47% |
| Cigna | Commercial | $2.00 | ↓ -44% |
| Aetna | EBR ASO | $2.00 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicare | $2.50 | ↓ -31% |
| PA Health & Wellness | PA Medicaid HMO | $2.75 | ↓ -24% |
| Coventry/First Health | Commercial | $3.50 | ↓ -3% |
| Private Health Care Systems | PPO | $4.00 | ↑ +11% |
| SelectCare | Commercial | $4.00 | ↑ +11% |
| Humana | Commercial | $4.25 | ↑ +18% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $5.99 | ↑ +66% |
| UPMC Work Partners | Workers Comp | $7.72 | ↑ +114% |
| Highmark BCBS of PA | Managed Care - Social Mission | $17.24 | ↑ +379% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $17.33 | ↑ +381% |
| UPMC Health Plan | Commercial | $23.02 | ↑ +539% |
| Highmark BCBS of PA | Managed Care | $23.08 | ↑ +541% |
| Highmark BCBS of PA | Commercial - Indemnity | $23.20 | ↑ +544% |
| Highmark BCBS of PA | UPMC Emergent | $46.17 | ↑ +1183% |
Visitor-reported prices
Comments
Composite drsg <= 16 sq in at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $3.60 | $3.17 – $18.76 |
| UPMC Mercy | Pittsburgh | $3.60 | $5.93 – $14.81 |
| UPMC Passavant-McCandless | Pittsburgh | $3.60 | $5.99 – $27.22 |
| UPMC Presbyterian | Pittsburgh | $4.80 | $3.61 – $30.33 |
| UPMC Altoona | Altoona | $3.00 | $2.50 – $18.76 |
| UPMC East | Monroeville | $3.60 | $1.25 – $18.76 |
| UPMC Hamot | Erie | $3.00 | $5.93 – $7.72 |
| UPMC Northwest | Seneca | $3.00 | $7.72 – $22.70 |