healthcosts.net
Enzyme histochemistry at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$381.60
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.
?
What you pay up front if you don't use insurance.
$636.00
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.
$79.84 with UPMC Health Plan vs $856.70 with Aetna — 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 | Commercial | $79.84 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $95.40 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $104.09 | ↓ -73% |
| UPMC Health Plan | Managed Medicaid | $128.75 | ↓ -66% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $128.75 | ↓ -66% |
| Aetna | Neighborhood Network | $160.27 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicaid | $173.59 | ↓ -55% |
| Aetna | Home Depot Employer Group | $174.26 | ↓ -54% |
| Aetna | NBR ASO/FI | $178.08 | ↓ -53% |
| Cigna | New Business ASO | $178.08 | ↓ -53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $180.94 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $182.73 | ↓ -52% |
| PA Health & Wellness | PA Medicaid HMO | $199.48 | ↓ -48% |
| Aetna | EBR FI | $241.68 | ↓ -37% |
| Highmark BCBS of PA | Managed Care | $242.33 | ↓ -36% |
| Aetna | EBR ASO | $254.40 | ↓ -33% |
| Cigna | Commercial | $254.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $301.27 | ↓ -21% |
| Highmark BCBS of PA | Commercial - Indemnity | $403.48 | ↑ +6% |
| Coventry/First Health | Commercial | $445.20 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $484.66 | ↑ +27% |
| Private Health Care Systems | PPO | $508.80 | ↑ +33% |
| SelectCare | Commercial | $508.80 | ↑ +33% |
| Humana | Commercial | $540.60 | ↑ +42% |
| UPMC Health Plan | Managed Medicare | $672.43 | ↑ +76% |
| Aetna of PA | Medicare | $817.76 | ↑ +114% |
| Highmark Wholecare (prev Gateway) | Medicare | $841.05 | ↑ +120% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $841.13 | ↑ +120% |
| Aetna | Medicare | $856.70 | ↑ +125% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Enzyme histochemistry at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $388.80 | $79.18 – $817.76 |
| UPMC Passavant-McCandless | Pittsburgh | $229.80 | $79.65 – $856.70 |
| UPMC Presbyterian | Pittsburgh | $2,529.60 | $8.89 – $856.70 |
| UPMC Northwest | Seneca | $573.60 | $79.68 – $817.76 |
| UPMC Somerset | Somerset | $1,472.40 | $8.52 – $1,840.50 |
| UPMC Williamsport | Williamsport | $471.60 | $9.48 – $628.80 |