healthcosts.net
Decalcification at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$111.60
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.
$186.00
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.
$18.39 with UPMC Health Plan vs $158.10 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $18.39 | ↓ -84% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $18.39 | ↓ -84% |
| UPMC Health Plan | Commercial | $23.04 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $24.80 | ↓ -78% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $26.10 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $28.49 | ↓ -74% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $32.46 | ↓ -71% |
| Aetna | Medicare | $46.50 | ↓ -58% |
| Aetna | Neighborhood Network | $46.87 | ↓ -58% |
| Aetna | Home Depot Employer Group | $50.96 | ↓ -54% |
| Aetna | NBR ASO/FI | $52.08 | ↓ -53% |
| Cigna | New Business ASO | $52.08 | ↓ -53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $56.43 | ↓ -49% |
| Aetna | EBR FI | $70.68 | ↓ -37% |
| Aetna | EBR ASO | $74.40 | ↓ -33% |
| Cigna | Commercial | $74.40 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $75.58 | ↓ -32% |
| Highmark Wholecare (prev Gateway) | Medicare | $93.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $93.96 | ↓ -16% |
| Highmark BCBS of PA | Commercial - Indemnity | $125.84 | ↑ +13% |
| Coventry/First Health | Commercial | $130.20 | ↑ +17% |
| UPMC Work Partners | Workers Comp | $142.12 | ↑ +27% |
| Private Health Care Systems | PPO | $148.80 | ↑ +33% |
| SelectCare | Commercial | $148.80 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $151.16 | ↑ +35% |
| Humana | Commercial | $158.10 | ↑ +42% |
Visitor-reported prices
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Decalcification at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $121.20 | $18.39 – $181.80 |
| UPMC Passavant-McCandless | Pittsburgh | $334.20 | $18.39 – $204.85 |
| UPMC Presbyterian | Pittsburgh | $645.60 | $7.43 – $914.60 |
| UPMC Muncy | Muncy | $388.20 | $7.92 – $517.60 |
| UPMC Northwest | Seneca | $102.00 | $18.39 – $144.50 |
| UPMC Somerset | Somerset | $124.80 | $7.12 – $156.00 |
| UPMC Wellsboro | Wellsboro | $469.60 | $7.92 – $528.30 |
| UPMC Williamsport | Williamsport | $388.20 | $7.92 – $517.60 |