healthcosts.net
Guid loc target vol rad tx at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$843.60
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.
$1,406.00
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.
$16.04 with Highmark BCBS of PA vs $1,195.10 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 | $16.04 | ↓ -98% |
| Highmark BCBS of PA | Managed Care - Social Mission | $35.72 | ↓ -96% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $46.44 | ↓ -94% |
| Highmark BCBS of PA | Managed Care | $47.84 | ↓ -94% |
| Highmark BCBS of PA | Commercial - Indemnity | $62.19 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $87.49 | ↓ -90% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $87.49 | ↓ -90% |
| Highmark BCBS of PA | UPMC Emergent | $95.68 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $117.96 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $124.17 | ↓ -85% |
| PA Health & Wellness | PA Medicaid HMO | $135.55 | ↓ -84% |
| Aetna | Medicare | $351.50 | ↓ -58% |
| Aetna | Neighborhood Network | $354.31 | ↓ -58% |
| Aetna | Home Depot Employer Group | $385.24 | ↓ -54% |
| Aetna | NBR ASO/FI | $393.68 | ↓ -53% |
| Cigna | New Business ASO | $393.68 | ↓ -53% |
| Aetna | EBR FI | $534.28 | ↓ -37% |
| UPMC Health Plan | Commercial | $546.06 | ↓ -35% |
| Aetna | EBR ASO | $562.40 | ↓ -33% |
| Cigna | Commercial | $562.40 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $703.00 | ↓ -17% |
| Coventry/First Health | Commercial | $984.20 | ↑ +17% |
| Private Health Care Systems | PPO | $1,124.80 | ↑ +33% |
| SelectCare | Commercial | $1,124.80 | ↑ +33% |
| Humana | Commercial | $1,195.10 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Guid loc target vol rad tx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $823.20 | $16.04 – $1,166.20 |
| UPMC Presbyterian | Pittsburgh | $1,322.40 | $16.04 – $1,873.40 |
| UPMC Northwest | Seneca | $1,214.40 | $41.25 – $1,720.40 |
| UPMC Somerset | Somerset | $300.60 | $15.73 – $375.75 |
| UPMC Williamsport | Williamsport | $292.20 | $81.68 – $438.30 |