healthcosts.net
Hla i low res one antigen equiv ea at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$1,253.40
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.
$2,089.00
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.
$64.18 with UPMC Health Plan vs $1,175.55 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 | $64.18 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $73.46 | ↓ -94% |
| Aetna of PA | Medicare | $78.05 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $80.27 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $80.28 | ↓ -94% |
| Aetna | Medicare | $81.76 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $87.34 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $87.34 | ↓ -93% |
| UPMC Health Plan | Commercial | $93.32 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $117.75 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $123.95 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $135.31 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $192.87 | ↓ -85% |
| Highmark BCBS of PA | Managed Care - Social Mission | $335.27 | ↓ -73% |
| Aetna | Neighborhood Network | $348.52 | ↓ -72% |
| Aetna | Home Depot Employer Group | $378.94 | ↓ -70% |
| Aetna | NBR ASO/FI | $387.24 | ↓ -69% |
| Cigna | New Business ASO | $387.24 | ↓ -69% |
| Highmark BCBS of PA | Managed Care | $449.01 | ↓ -64% |
| Aetna | EBR FI | $525.54 | ↓ -58% |
| Aetna | EBR ASO | $553.20 | ↓ -56% |
| Cigna | Commercial | $553.20 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $558.22 | ↓ -55% |
| Highmark BCBS of PA | Commercial - Indemnity | $747.61 | ↓ -40% |
| Highmark BCBS of PA | UPMC Emergent | $898.03 | ↓ -28% |
| Coventry/First Health | Commercial | $968.10 | ↓ -23% |
| Private Health Care Systems | PPO | $1,106.40 | ↓ -12% |
| SelectCare | Commercial | $1,106.40 | ↓ -12% |
| Humana | Commercial | $1,175.55 | ↓ -6% |
Visitor-reported prices
Comments
Hla i low res one antigen equiv ea at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,328.40 | $69.07 – $1,258.00 |
| UPMC Mercy | Pittsburgh | $1,253.40 | $61.96 – $1,185.30 |
| UPMC Presbyterian | Pittsburgh | $1,253.40 | $73.46 – $1,775.65 |
| UPMC Muncy | Muncy | $651.00 | $73.46 – $868.00 |
| UPMC Northwest | Seneca | $837.60 | $67.41 – $1,186.60 |
| UPMC Wellsboro | Wellsboro | $956.80 | $73.46 – $929.70 |
| UPMC Williamsport | Williamsport | $791.40 | $73.46 – $1,055.20 |