healthcosts.net
Ghs musc tst done w/nerv tst lim at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$322.80
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.
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What you pay up front if you don't use insurance.
$538.00
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.
$44.85 with Highmark BCBS of PA vs $457.30 with Humana — 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 | $44.85 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $45.88 | ↓ -86% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $45.88 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $61.86 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $65.11 | ↓ -80% |
| PA Health & Wellness | PA Medicaid HMO | $71.08 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $76.87 | ↓ -76% |
| Highmark BCBS of PA | Managed Care - Social Mission | $117.15 | ↓ -64% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $129.81 | ↓ -60% |
| Aetna | Medicare | $134.50 | ↓ -58% |
| Aetna | Neighborhood Network | $135.58 | ↓ -58% |
| Aetna | Home Depot Employer Group | $147.41 | ↓ -54% |
| Aetna | NBR ASO/FI | $150.64 | ↓ -53% |
| Cigna | New Business ASO | $150.64 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $156.89 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Indemnity | $173.85 | ↓ -46% |
| UPMC Health Plan | Commercial | $187.11 | ↓ -42% |
| Aetna | EBR FI | $204.44 | ↓ -37% |
| Aetna | EBR ASO | $215.20 | ↓ -33% |
| Cigna | Commercial | $215.20 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $269.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $313.79 | ↓ -3% |
| Coventry/First Health | Commercial | $376.60 | ↑ +17% |
| Private Health Care Systems | PPO | $430.40 | ↑ +33% |
| SelectCare | Commercial | $430.40 | ↑ +33% |
| Humana | Commercial | $457.30 | ↑ +42% |
Visitor-reported prices
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Ghs musc tst done w/nerv tst lim at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $316.80 | $44.43 – $475.20 |
| UPMC Passavant-McCandless | Pittsburgh | $268.80 | $44.85 – $380.80 |
| UPMC Presbyterian | Pittsburgh | $357.60 | $33.47 – $506.60 |
| UPMC Northwest | Seneca | $260.40 | $45.88 – $368.90 |