healthcosts.net
Inj cntr knee arthro incl ct/mri at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$590.40
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.
$984.00
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.
$85.72 with Highmark BCBS of PA vs $836.40 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $85.72 | ↓ -85% |
| Premier Comp Solutions | Worker's Comp | $156.70 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $168.45 | ↓ -71% |
| Highmark BCBS of PA | Managed Care - Social Mission | $190.85 | ↓ -68% |
| Aetna | Medicare | $246.00 | ↓ -58% |
| Aetna | Neighborhood Network | $247.97 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $248.10 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $255.60 | ↓ -57% |
| Aetna | Home Depot Employer Group | $269.62 | ↓ -54% |
| Aetna | NBR ASO/FI | $275.52 | ↓ -53% |
| Cigna | New Business ASO | $275.52 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $332.27 | ↓ -44% |
| UPMC Health Plan | Commercial | $337.15 | ↓ -43% |
| Aetna | EBR FI | $373.92 | ↓ -37% |
| Aetna | EBR ASO | $393.60 | ↓ -33% |
| Cigna | Commercial | $393.60 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $492.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $511.20 | ↓ -13% |
| PA Health & Wellness | PA Medicaid HMO | $541.20 | ↓ -8% |
| Coventry/First Health | Commercial | $688.80 | ↑ +17% |
| Private Health Care Systems | PPO | $787.20 | ↑ +33% |
| SelectCare | Commercial | $787.20 | ↑ +33% |
| Humana | Commercial | $836.40 | ↑ +42% |
Visitor-reported prices
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Inj cntr knee arthro incl ct/mri at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $286.80 | $85.72 – $406.30 |
| UPMC Mercy | Pittsburgh | $1,513.80 | $84.91 – $2,270.70 |
| UPMC Presbyterian | Pittsburgh | $345.60 | $39.90 – $489.60 |
| UPMC Muncy | Muncy | $969.00 | $42.56 – $1,292.00 |
| UPMC Northwest | Seneca | $162.00 | $67.50 – $420.55 |
| UPMC Somerset | Somerset | $186.60 | $38.24 – $349.54 |
| UPMC Wellsboro | Wellsboro | $1,172.00 | $42.56 – $1,318.50 |
| UPMC Williamsport | Williamsport | $969.00 | $42.56 – $1,292.00 |