healthcosts.net
Electron microscopy diagnostic at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,203.80
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.
$3,673.00
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.
$75.90 with UPMC Health Plan vs $856.70 with Aetna — 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 | $75.90 | ↓ -97% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $75.90 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $102.33 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $107.72 | ↓ -95% |
| PA Health & Wellness | PA Medicaid HMO | $117.59 | ↓ -95% |
| UPMC Health Plan | Commercial | $119.38 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $148.54 | ↓ -93% |
| Aetna | Neighborhood Network | $195.05 | ↓ -91% |
| Aetna | Home Depot Employer Group | $212.08 | ↓ -90% |
| Aetna | NBR ASO/FI | $216.72 | ↓ -90% |
| Cigna | New Business ASO | $216.72 | ↓ -90% |
| Highmark BCBS of PA | Managed Care - Social Mission | $258.22 | ↓ -88% |
| Aetna | EBR FI | $294.12 | ↓ -87% |
| Aetna | EBR ASO | $309.60 | ↓ -86% |
| Cigna | Commercial | $309.60 | ↓ -86% |
| Highmark BCBS of PA | Managed Care | $345.83 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $355.83 | ↓ -84% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $429.93 | ↓ -80% |
| Coventry/First Health | Commercial | $541.80 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity | $575.80 | ↓ -74% |
| Private Health Care Systems | PPO | $619.20 | ↓ -72% |
| SelectCare | Commercial | $619.20 | ↓ -72% |
| Humana | Commercial | $657.90 | ↓ -70% |
| UPMC Health Plan | Managed Medicare | $672.43 | ↓ -69% |
| Highmark BCBS of PA | UPMC Emergent | $691.65 | ↓ -69% |
| Aetna of PA | Medicare | $817.76 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicare | $841.05 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $841.13 | ↓ -62% |
| Aetna | Medicare | $856.70 | ↓ -61% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Electron microscopy diagnostic at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $554.40 | $75.90 – $831.60 |
| UPMC Passavant-McCandless | Pittsburgh | $578.40 | $75.90 – $856.70 |
| UPMC Presbyterian | Pittsburgh | $6,864.00 | $21.00 – $856.70 |
| UPMC Northwest | Seneca | $1,386.00 | $75.90 – $1,963.50 |
| UPMC Somerset | Somerset | $1,472.40 | $20.12 – $1,323.75 |
| UPMC Williamsport | Williamsport | $1,084.80 | $22.40 – $1,446.40 |