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Diagnostic Mammogram (both breasts) at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$511.80
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.
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What you pay up front if you don't use insurance.
$853.00
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.
$74.31 with Highmark BCBS of PA vs $725.05 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 | $74.31 | ↓ -85% |
| UPMC Health Plan | Managed Medicaid | $142.84 | ↓ -72% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $142.84 | ↓ -72% |
| Highmark BCBS of PA | Managed Care - Social Mission | $165.45 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicaid | $192.57 | ↓ -62% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $202.71 | ↓ -60% |
| Aetna | Medicare | $213.25 | ↓ -58% |
| Aetna | Neighborhood Network | $214.96 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $215.08 | ↓ -58% |
| PA Health & Wellness | PA Medicaid HMO | $221.29 | ↓ -57% |
| Highmark BCBS of PA | Managed Care | $221.58 | ↓ -57% |
| Aetna | Home Depot Employer Group | $233.72 | ↓ -54% |
| Aetna | NBR ASO/FI | $238.84 | ↓ -53% |
| Cigna | New Business ASO | $238.84 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $288.05 | ↓ -44% |
| UPMC Health Plan | Commercial | $320.02 | ↓ -37% |
| Aetna | EBR FI | $324.14 | ↓ -37% |
| Aetna | EBR ASO | $341.20 | ↓ -33% |
| Cigna | Commercial | $341.20 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $426.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $443.16 | ↓ -13% |
| Coventry/First Health | Commercial | $597.10 | ↑ +17% |
| Private Health Care Systems | PPO | $682.40 | ↑ +33% |
| SelectCare | Commercial | $682.40 | ↑ +33% |
| Humana | Commercial | $725.05 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Diagnostic Mammogram (both breasts) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $572.40 | $74.31 – $877.68 |
| UPMC Hamot | Erie | $612.00 | $73.61 – $714.00 |
| UPMC Carlisle | Carlisle | $310.20 | $70.83 – $611.06 |
| UPMC Altoona | Altoona | $583.20 | $73.61 – $777.60 |
| UPMC Bedford | Everett | $609.00 | $136.34 – $913.50 |
| UPMC Cole | Coudersport | $458.40 | $136.34 – $611.20 |
| UPMC Community Osteopathic | Harrisburg | $310.20 | $103.40 – $675.02 |
| UPMC Hanover | Hanover | $310.20 | $98.23 – $611.06 |