healthcosts.net
Ghs sensitivity (per antimicro) at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$74.40
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.
$124.00
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.
$6.46 with UPMC Health Plan vs $105.40 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicare | $6.46 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $7.39 | ↓ -90% |
| UPMC Health Plan | Commercial | $7.79 | ↓ -90% |
| Aetna of PA | Medicare | $7.85 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicare | $8.08 | ↓ -89% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $8.08 | ↓ -89% |
| Aetna | Medicare | $8.23 | ↓ -89% |
| UPMC Health Plan | Managed Medicaid | $8.80 | ↓ -88% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $8.80 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $11.86 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.49 | ↓ -83% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $13.45 | ↓ -82% |
| PA Health & Wellness | PA Medicaid HMO | $13.63 | ↓ -82% |
| Highmark BCBS of PA | Managed Care - Social Mission | $23.39 | ↓ -69% |
| Aetna | Neighborhood Network | $31.25 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $31.32 | ↓ -58% |
| Aetna | Home Depot Employer Group | $33.98 | ↓ -54% |
| Aetna | NBR ASO/FI | $34.72 | ↓ -53% |
| Cigna | New Business ASO | $34.72 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $38.94 | ↓ -48% |
| Aetna | EBR FI | $47.12 | ↓ -37% |
| Aetna | EBR ASO | $49.60 | ↓ -33% |
| Cigna | Commercial | $49.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $52.15 | ↓ -30% |
| Highmark BCBS of PA | UPMC Emergent | $62.65 | ↓ -16% |
| Coventry/First Health | Commercial | $86.80 | ↑ +17% |
| Private Health Care Systems | PPO | $99.20 | ↑ +33% |
| SelectCare | Commercial | $99.20 | ↑ +33% |
| Humana | Commercial | $105.40 | ↑ +42% |
Visitor-reported prices
Comments
Ghs sensitivity (per antimicro) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $68.40 | $6.95 – $96.90 |
| UPMC Mercy | Pittsburgh | $76.20 | $6.24 – $114.30 |
| UPMC Presbyterian | Pittsburgh | $520.80 | $7.39 – $737.80 |
| UPMC Muncy | Muncy | $111.60 | $7.39 – $148.80 |
| UPMC Northwest | Seneca | $34.80 | $6.78 – $49.30 |
| UPMC Somerset | Somerset | $42.00 | $7.39 – $47.25 |
| UPMC Wellsboro | Wellsboro | $135.20 | $7.39 – $152.10 |