healthcosts.net
Infectious agent antigen immunoassay ql/sq multi step rotavirus at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$155.40
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.
$259.00
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.
$10.34 with UPMC Health Plan vs $220.15 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 | $10.34 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $11.84 | ↓ -92% |
| Aetna of PA | Medicare | $12.58 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.94 | ↓ -92% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12.94 | ↓ -92% |
| Aetna | Medicare | $13.18 | ↓ -92% |
| UPMC Health Plan | Commercial | $22.03 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $31.66 | ↓ -80% |
| Highmark BCBS of PA | Managed Care - Social Mission | $55.03 | ↓ -65% |
| Aetna | Neighborhood Network | $65.27 | ↓ -58% |
| Aetna | Home Depot Employer Group | $70.97 | ↓ -54% |
| Aetna | NBR ASO/FI | $72.52 | ↓ -53% |
| Cigna | New Business ASO | $72.52 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $73.70 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $91.62 | ↓ -41% |
| Aetna | EBR FI | $98.42 | ↓ -37% |
| Aetna | EBR ASO | $103.60 | ↓ -33% |
| Cigna | Commercial | $103.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $122.71 | ↓ -21% |
| PA Health & Wellness | PA Medicaid HMO | $142.45 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $147.40 | ↓ -5% |
| Coventry/First Health | Commercial | $181.30 | ↑ +17% |
| Private Health Care Systems | PPO | $207.20 | ↑ +33% |
| SelectCare | Commercial | $207.20 | ↑ +33% |
| Humana | Commercial | $220.15 | ↑ +42% |
Visitor-reported prices
Comments
Infectious agent antigen immunoassay ql/sq multi step rotavirus at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $115.80 | $11.13 – $164.05 |
| UPMC Presbyterian | Pittsburgh | $142.20 | $8.77 – $201.45 |
| UPMC Muncy | Muncy | $144.00 | $9.36 – $192.00 |
| UPMC Northwest | Seneca | $108.00 | $10.86 – $153.00 |
| UPMC Somerset | Somerset | $66.60 | $8.41 – $83.25 |
| UPMC Wellsboro | Wellsboro | $174.40 | $9.36 – $196.20 |
| UPMC Williamsport | Williamsport | $144.00 | $9.36 – $192.00 |