healthcosts.net
Hla class i high defin qual at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$411.60
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.
$686.00
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.
$143.25 with Highmark BCBS of PA vs $667.01 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 | $143.25 | ↓ -65% |
| UPMC Health Plan | Managed Medicaid | $146.45 | ↓ -64% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $146.45 | ↓ -64% |
| Aetna | Medicare | $171.50 | ↓ -58% |
| Aetna | Neighborhood Network | $172.87 | ↓ -58% |
| Aetna | Home Depot Employer Group | $187.96 | ↓ -54% |
| Aetna | NBR ASO/FI | $192.08 | ↓ -53% |
| Cigna | New Business ASO | $192.08 | ↓ -53% |
| Highmark Wholecare (prev Gateway) | Medicaid | $197.45 | ↓ -52% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $207.84 | ↓ -50% |
| PA Health & Wellness | PA Medicaid HMO | $226.90 | ↓ -45% |
| Highmark BCBS of PA | Managed Care - Social Mission | $249.02 | ↓ -39% |
| Aetna | EBR FI | $260.68 | ↓ -37% |
| Aetna | EBR ASO | $274.40 | ↓ -33% |
| Cigna | Commercial | $274.40 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $279.53 | ↓ -32% |
| UPMC Work Partners | Workers Comp | $319.97 | ↓ -22% |
| Highmark BCBS of PA | Managed Care | $333.51 | ↓ -19% |
| Aetna of PA | Medicare | $339.94 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $343.00 | ↓ -17% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $349.65 | ↓ -15% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $414.62 | ↑ +1% |
| Coventry/First Health | Commercial | $480.20 | ↑ +17% |
| Private Health Care Systems | PPO | $548.80 | ↑ +33% |
| SelectCare | Commercial | $548.80 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity | $555.29 | ↑ +35% |
| Humana | Commercial | $583.10 | ↑ +42% |
| UPMC Health Plan | Commercial | $637.31 | ↑ +55% |
| Highmark BCBS of PA | UPMC Emergent | $667.01 | ↑ +62% |
Visitor-reported prices
Comments
Hla class i high defin qual at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $435.60 | $143.25 – $582.25 |
| UPMC Mercy | Pittsburgh | $411.60 | $141.90 – $617.40 |
| UPMC Presbyterian | Pittsburgh | $585.00 | $133.14 – $828.75 |
| UPMC Northwest | Seneca | $409.20 | $146.45 – $579.70 |
| UPMC Somerset | Somerset | $1,800.60 | $140.47 – $2,250.75 |
| UPMC Williamsport | Williamsport | $556.80 | $146.45 – $742.40 |