healthcosts.net
ER Visit (level 2) at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$336.60
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.
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What you pay up front if you don't use insurance.
$561.00
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.
$36.28 with UPMC Health Plan vs $646.64 with Highmark BCBS of PA — 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 | $36.28 | ↓ -89% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $36.28 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $51.49 | ↓ -85% |
| PA Health & Wellness | PA Medicaid HMO | $56.20 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $79.81 | ↓ -76% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $83.84 | ↓ -75% |
| UPMC Health Plan | Managed Medicare | $130.36 | ↓ -61% |
| Aetna | Neighborhood Network | $141.37 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicaid | $144.80 | ↓ -57% |
| Aetna | Home Depot Employer Group | $153.71 | ↓ -54% |
| Aetna | NBR ASO/FI | $157.08 | ↓ -53% |
| Cigna | New Business ASO | $157.08 | ↓ -53% |
| Aetna of PA | Medicare | $158.53 | ↓ -53% |
| Highmark Wholecare (prev Gateway) | Medicare | $163.04 | ↓ -52% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $163.06 | ↓ -52% |
| Aetna | Medicare | $166.08 | ↓ -51% |
| UPMC Health Plan | Commercial | $188.77 | ↓ -44% |
| Aetna | EBR FI | $213.18 | ↓ -37% |
| Aetna | EBR ASO | $224.40 | ↓ -33% |
| Cigna | Commercial | $224.40 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $241.43 | ↓ -28% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $242.67 | ↓ -28% |
| Highmark BCBS of PA | Managed Care | $323.32 | ↓ -4% |
| Highmark BCBS of PA | Commercial - Indemnity | $325.00 | ↓ -3% |
| Coventry/First Health | Commercial | $392.70 | ↑ +17% |
| Private Health Care Systems | PPO | $448.80 | ↑ +33% |
| SelectCare | Commercial | $448.80 | ↑ +33% |
| Humana | Commercial | $476.85 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $646.64 | ↑ +92% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 2) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $424.20 | $36.28 – $600.95 |
| UPMC Magee | Pittsburgh | $354.00 | $36.28 – $542.80 |
| UPMC Mercy | Pittsburgh | $564.00 | $36.28 – $846.00 |
| UPMC Presbyterian | Pittsburgh | $620.40 | $36.28 – $878.90 |
| UPMC East | Monroeville | $652.80 | $36.28 – $870.40 |
| UPMC Hamot | Erie | $640.20 | $36.28 – $746.90 |
| UPMC Carlisle | Carlisle | $570.60 | $34.91 – $808.35 |
| UPMC Altoona | Altoona | $496.20 | $35.00 – $661.60 |