healthcosts.net
ER Visit (level 1, minor) at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$238.80
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.
?
What you pay up front if you don't use insurance.
$398.00
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.
$51.60 with UPMC Work Partners vs $427.09 with Highmark BCBS of PA — 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 Work Partners | Workers Comp | $51.60 | ↓ -78% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $55.38 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $66.90 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $72.48 | ↓ -70% |
| Aetna of PA | Medicare | $88.15 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicare | $90.66 | ↓ -62% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.67 | ↓ -62% |
| Aetna | Medicare | $92.34 | ↓ -61% |
| Aetna | Neighborhood Network | $100.30 | ↓ -58% |
| Aetna | Home Depot Employer Group | $109.05 | ↓ -54% |
| Aetna | NBR ASO/FI | $111.44 | ↓ -53% |
| Cigna | New Business ASO | $111.44 | ↓ -53% |
| UPMC Health Plan | Commercial | $126.15 | ↓ -47% |
| Aetna | EBR FI | $151.24 | ↓ -37% |
| Aetna | EBR ASO | $159.20 | ↓ -33% |
| Cigna | Commercial | $159.20 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $159.46 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $160.27 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $213.55 | ↓ -11% |
| Highmark BCBS of PA | Commercial - Indemnity | $214.65 | ↓ -10% |
| PA Health & Wellness | PA Medicaid HMO | $218.90 | ↓ -8% |
| Coventry/First Health | Commercial | $278.60 | ↑ +17% |
| Private Health Care Systems | PPO | $318.40 | ↑ +33% |
| SelectCare | Commercial | $318.40 | ↑ +33% |
| Humana | Commercial | $338.30 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $427.09 | ↑ +79% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 1, minor) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $183.60 | $51.60 – $260.10 |
| UPMC Magee | Pittsburgh | $223.80 | $51.60 – $343.16 |
| UPMC Mercy | Pittsburgh | $300.00 | $52.16 – $450.00 |
| UPMC Presbyterian | Pittsburgh | $308.40 | $52.16 – $436.90 |
| UPMC East | Monroeville | $260.40 | $51.60 – $347.20 |
| UPMC Hamot | Erie | $384.60 | $51.60 – $448.70 |
| UPMC Carlisle | Carlisle | $391.20 | $21.05 – $554.20 |
| UPMC Altoona | Altoona | $374.40 | $21.00 – $499.20 |