healthcosts.net
Conjugated estrogens 25 mg solution for injection at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$860.00
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.
$1,075.00
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.
$60.25 with Highmark BCBS of PA vs $913.75 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 | $60.25 | ↓ -93% |
| Highmark BCBS of PA | Managed Care - Social Mission | $173.51 | ↓ -80% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $174.40 | ↓ -80% |
| Highmark BCBS of PA | Managed Care | $232.36 | ↓ -73% |
| Highmark BCBS of PA | Commercial - Indemnity | $233.56 | ↓ -73% |
| UPMC Health Plan | Managed Medicaid | $247.55 | ↓ -71% |
| Aetna | Neighborhood Network | $270.90 | ↓ -69% |
| UPMC Work Partners | Workers Comp | $277.67 | ↓ -68% |
| Aetna | Home Depot Employer Group | $294.55 | ↓ -66% |
| Aetna | NBR ASO/FI | $301.00 | ↓ -65% |
| Cigna | New Business ASO | $301.00 | ↓ -65% |
| UPMC Health Plan | Managed Medicare | $338.50 | ↓ -61% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $392.06 | ↓ -54% |
| PA Health & Wellness | PA Medicaid HMO | $392.06 | ↓ -54% |
| Aetna | EBR FI | $408.50 | ↓ -53% |
| Aetna of PA | Medicare | $411.66 | ↓ -52% |
| Highmark Wholecare (prev Gateway) | Medicare | $423.39 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $423.42 | ↓ -51% |
| Aetna | EBR ASO | $430.00 | ↓ -50% |
| Cigna | Commercial | $430.00 | ↓ -50% |
| Aetna | Medicare | $431.27 | ↓ -50% |
| Highmark BCBS of PA | UPMC Emergent | $464.72 | ↓ -46% |
| UPMC Health Plan | Commercial | $482.24 | ↓ -44% |
| Coventry/First Health | Commercial | $752.50 | ↓ -13% |
| Private Health Care Systems | PPO | $860.00 | ↑ +0% |
| SelectCare | Commercial | $860.00 | ↑ +0% |
| Humana | Commercial | $913.75 | ↑ +6% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Conjugated estrogens 25 mg solution for injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,431.00 | $60.25 – $431.27 |
| UPMC Presbyterian | Pittsburgh | $1,431.00 | $60.25 – $2,027.25 |
| UPMC Western Psychiatric | Pittsburgh | $1,431.00 | $59.04 – $2,027.25 |
| UPMC Muncy | Muncy | $1,375.20 | $142.95 – $857.70 |
| UPMC Somerset | Somerset | $220.80 | $59.08 – $392.06 |
| UPMC Wellsboro | Wellsboro | $1,375.20 | $171.54 – $857.70 |
| UPMC Williamsport | Williamsport | $762.40 | $258.45 – $857.70 |