healthcosts.net
Endo cath bile duct s&i at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$950.40
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.
$1,584.00
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.
$179.43 with Highmark BCBS of PA vs $1,346.40 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $179.43 | ↓ -81% |
| UPMC Health Plan | Commercial | $269.68 | ↓ -72% |
| UPMC Work Partners | Workers Comp | $385.46 | ↓ -59% |
| Aetna | Medicare | $396.00 | ↓ -58% |
| Aetna | Neighborhood Network | $399.17 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $399.50 | ↓ -58% |
| Aetna | Home Depot Employer Group | $434.02 | ↓ -54% |
| Aetna | NBR ASO/FI | $443.52 | ↓ -53% |
| Cigna | New Business ASO | $443.52 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $519.33 | ↓ -45% |
| Highmark BCBS of PA | Managed Care | $535.04 | ↓ -44% |
| Aetna | EBR FI | $601.92 | ↓ -37% |
| Aetna | EBR ASO | $633.60 | ↓ -33% |
| Cigna | Commercial | $633.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $695.53 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $792.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $871.20 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $1,070.08 | ↑ +13% |
| Coventry/First Health | Commercial | $1,108.80 | ↑ +17% |
| Private Health Care Systems | PPO | $1,267.20 | ↑ +33% |
| SelectCare | Commercial | $1,267.20 | ↑ +33% |
| Humana | Commercial | $1,346.40 | ↑ +42% |
Visitor-reported prices
Comments
Endo cath bile duct s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $982.20 | $179.43 – $1,390.60 |
| UPMC Mercy | Pittsburgh | $877.20 | $177.74 – $1,315.80 |
| UPMC Presbyterian | Pittsburgh | $1,486.80 | $179.43 – $2,106.30 |
| UPMC Muncy | Muncy | $1,216.80 | $304.20 – $1,622.40 |
| UPMC Somerset | Somerset | $525.00 | $175.94 – $656.25 |
| UPMC Wellsboro | Wellsboro | $1,471.20 | $331.02 – $1,655.10 |
| UPMC Williamsport | Williamsport | $1,216.80 | $385.46 – $1,622.40 |