Foam drsg <=16 sq in without bdr at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$6.00
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.
$10.00
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.
$2.00 with Aetna vs $103.34 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 |
|---|---|---|---|
| Aetna | Medicare | $2.00 | ↓ -67% |
| Aetna | Neighborhood Network | $2.02 | ↓ -66% |
| Aetna | Home Depot Employer Group | $2.19 | ↓ -64% |
| Cigna | New Business ASO | $2.24 | ↓ -63% |
| Aetna | NBR ASO/FI | $2.24 | ↓ -63% |
| Aetna | EBR FI | $3.04 | ↓ -49% |
| Cigna | Commercial | $3.20 | ↓ -47% |
| Aetna | EBR ASO | $3.20 | ↓ -47% |
| Highmark Wholecare (prev Gateway) | Medicare | $4.00 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $4.40 | ↓ -27% |
| Coventry/First Health | Commercial | $5.60 | ↓ -7% |
| Private Health Care Systems | PPO | $6.40 | ↑ +7% |
| SelectCare | Commercial | $6.40 | ↑ +7% |
| Humana | Commercial | $6.80 | ↑ +13% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $13.40 | ↑ +123% |
| UPMC Work Partners | Workers Comp | $17.26 | ↑ +188% |
| Highmark BCBS of PA | Managed Care - Social Mission | $38.58 | ↑ +543% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $38.78 | ↑ +546% |
| UPMC Health Plan | Commercial | $51.33 | ↑ +756% |
| Highmark BCBS of PA | Managed Care | $51.67 | ↑ +761% |
| Highmark BCBS of PA | Commercial - Indemnity | $51.94 | ↑ +766% |
| Highmark BCBS of PA | UPMC Emergent | $103.34 | ↑ +1622% |
Visitor-reported prices
Comments
Foam drsg <=16 sq in without bdr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $8.40 | $7.04 – $41.83 |
| UPMC Mercy | Pittsburgh | $64.20 | $13.27 – $33.03 |
| UPMC Passavant-McCandless | Pittsburgh | $8.40 | $13.40 – $60.70 |
| UPMC Presbyterian | Pittsburgh | $28.20 | $8.10 – $67.63 |
| UPMC Altoona | Altoona | $4.20 | $3.50 – $41.83 |
| UPMC East | Monroeville | $118.20 | $1.75 – $41.83 |
| UPMC Hamot | Erie | $9.00 | $13.27 – $17.26 |
| UPMC Jameson | New Castle | $6.00 | $6.40 – $41.83 |