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Genetic tstg severe inh cond at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$5,325.60
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.
$8,876.00
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.
$1,509.63 with Highmark BCBS of PA vs $7,029.15 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,509.63 | ↓ -72% |
| Aetna | Neighborhood Network | $1,570.72 | ↓ -71% |
| Aetna | Home Depot Employer Group | $1,707.84 | ↓ -68% |
| Aetna | NBR ASO/FI | $1,745.24 | ↓ -67% |
| Cigna | New Business ASO | $1,745.24 | ↓ -67% |
| UPMC Health Plan | Managed Medicare | $2,114.09 | ↓ -60% |
| Aetna | EBR FI | $2,368.54 | ↓ -56% |
| UPMC Work Partners | Workers Comp | $2,419.96 | ↓ -55% |
| Aetna | EBR ASO | $2,493.20 | ↓ -53% |
| Cigna | Commercial | $2,493.20 | ↓ -53% |
| Aetna of PA | Medicare | $2,570.99 | ↓ -52% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,624.25 | ↓ -51% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,644.20 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,644.44 | ↓ -50% |
| Aetna | Medicare | $2,693.42 | ↓ -49% |
| PA Health & Wellness | PA Medicaid HMO | $3,428.15 | ↓ -36% |
| Highmark BCBS of PA | Managed Care | $3,514.58 | ↓ -34% |
| Coventry/First Health | Commercial | $4,363.10 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,369.35 | ↓ -18% |
| Private Health Care Systems | PPO | $4,986.40 | ↓ -6% |
| SelectCare | Commercial | $4,986.40 | ↓ -6% |
| Humana | Commercial | $5,298.05 | ↓ -1% |
| UPMC Health Plan | Commercial | $5,396.16 | ↑ +1% |
| Highmark BCBS of PA | Commercial - Indemnity | $5,851.78 | ↑ +10% |
| Highmark BCBS of PA | UPMC Emergent | $7,029.15 | ↑ +32% |
Visitor-reported prices
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Genetic tstg severe inh cond at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $12,863.40 | $395.08 – $2,693.42 |
| UPMC Mercy | Pittsburgh | $4,156.20 | $1,495.39 – $5,609.70 |
| UPMC Presbyterian | Pittsburgh | $18,150.60 | $409.68 – $6,305.54 |
| UPMC Muncy | Muncy | $13,264.80 | $980.25 – $5,228.00 |
| UPMC Northwest | Seneca | $14,904.00 | $910.40 – $2,644.44 |
| UPMC Wellsboro | Wellsboro | $13,264.80 | $1,122.30 – $5,611.50 |
| UPMC Williamsport | Williamsport | $11,622.60 | $852.01 – $2,644.20 |