healthcosts.net
Culture fungi skin/hair/nail at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$79.80
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.
$133.00
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.
$6.66 with UPMC Health Plan vs $113.05 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicare | $6.66 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $7.62 | ↓ -90% |
| Aetna of PA | Medicare | $8.10 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $8.33 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $8.33 | ↓ -90% |
| Aetna | Medicare | $8.48 | ↓ -89% |
| UPMC Health Plan | Managed Medicaid | $10.67 | ↓ -87% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $10.67 | ↓ -87% |
| UPMC Health Plan | Commercial | $14.05 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.39 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.14 | ↓ -81% |
| PA Health & Wellness | PA Medicaid HMO | $16.53 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $21.15 | ↓ -73% |
| Aetna | Neighborhood Network | $33.52 | ↓ -58% |
| Aetna | Home Depot Employer Group | $36.44 | ↓ -54% |
| Highmark BCBS of PA | Managed Care - Social Mission | $36.76 | ↓ -54% |
| Aetna | NBR ASO/FI | $37.24 | ↓ -53% |
| Cigna | New Business ASO | $37.24 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $49.24 | ↓ -38% |
| Aetna | EBR FI | $50.54 | ↓ -37% |
| Aetna | EBR ASO | $53.20 | ↓ -33% |
| Cigna | Commercial | $53.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $61.21 | ↓ -23% |
| Highmark BCBS of PA | Commercial - Indemnity | $81.98 | ↑ +3% |
| Coventry/First Health | Commercial | $93.10 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $98.47 | ↑ +23% |
| Private Health Care Systems | PPO | $106.40 | ↑ +33% |
| SelectCare | Commercial | $106.40 | ↑ +33% |
| Humana | Commercial | $113.05 | ↑ +42% |
Visitor-reported prices
Comments
Culture fungi skin/hair/nail at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $253.20 | $7.16 – $358.70 |
| UPMC Mercy | Pittsburgh | $80.40 | $6.43 – $120.60 |
| UPMC Presbyterian | Pittsburgh | $520.20 | $7.62 – $736.95 |
| UPMC Muncy | Muncy | $70.80 | $7.62 – $94.40 |
| UPMC Northwest | Seneca | $80.40 | $6.99 – $113.90 |
| UPMC Somerset | Somerset | $43.20 | $7.62 – $54.00 |
| UPMC Wellsboro | Wellsboro | $85.60 | $7.62 – $96.30 |
| UPMC Williamsport | Williamsport | $70.80 | $7.62 – $94.40 |