healthcosts.net
Impl neurostim electr perc at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$6,302.40
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.
$10,504.00
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.
$410.25 with UPMC Health Plan vs $8,928.40 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 Medicaid | $410.25 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $410.25 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $553.08 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $582.21 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $635.58 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -88% |
| UPMC Health Plan | Commercial | $1,039.93 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,640.37 | ↓ -74% |
| UPMC Work Partners | Workers Comp | $1,861.56 | ↓ -70% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,132.40 | ↓ -66% |
| Highmark BCBS of PA | Managed Care | $2,196.91 | ↓ -65% |
| Aetna | Neighborhood Network | $2,647.01 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,855.88 | ↓ -55% |
| Aetna | Home Depot Employer Group | $2,878.10 | ↓ -54% |
| Aetna | NBR ASO/FI | $2,941.12 | ↓ -53% |
| Cigna | New Business ASO | $2,941.12 | ↓ -53% |
| Aetna | EBR FI | $3,991.52 | ↓ -37% |
| Aetna | EBR ASO | $4,201.60 | ↓ -33% |
| Cigna | Commercial | $4,201.60 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $4,393.81 | ↓ -30% |
| UPMC Health Plan | Managed Medicare | $5,402.24 | ↓ -14% |
| Aetna of PA | Medicare | $6,569.79 | ↑ +4% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,756.87 | ↑ +7% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $6,757.50 | ↑ +7% |
| Aetna | Medicare | $6,882.63 | ↑ +9% |
| Coventry/First Health | Commercial | $7,352.80 | ↑ +17% |
| Private Health Care Systems | PPO | $8,403.20 | ↑ +33% |
| SelectCare | Commercial | $8,403.20 | ↑ +33% |
| Humana | Commercial | $8,928.40 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Impl neurostim electr perc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $6,504.60 | $410.25 – $9,214.85 |
| UPMC Mercy | Pittsburgh | $6,471.60 | $410.25 – $9,707.40 |
| UPMC Presbyterian | Pittsburgh | $6,688.20 | $410.25 – $9,474.95 |
| UPMC Northwest | Seneca | $4,795.80 | $410.25 – $6,794.05 |
| UPMC Somerset | Somerset | $12,736.80 | $410.25 – $15,921.00 |
| UPMC Williamsport | Williamsport | $4,750.20 | $410.25 – $6,333.60 |
| UPMC Muncy | Muncy | not published | $410.25 – $1,991.43 |