healthcosts.net
Inj proc elbow arthro at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$381.60
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.
$636.00
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.
$131.35 with Highmark BCBS of PA vs $783.37 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 | $131.35 | ↓ -66% |
| Aetna | Medicare | $159.00 | ↓ -58% |
| Aetna | Neighborhood Network | $160.27 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $167.97 | ↓ -56% |
| Aetna | Home Depot Employer Group | $174.26 | ↓ -54% |
| Aetna | NBR ASO/FI | $178.08 | ↓ -53% |
| Cigna | New Business ASO | $178.08 | ↓ -53% |
| UPMC Health Plan | Commercial | $232.68 | ↓ -39% |
| Aetna | EBR FI | $241.68 | ↓ -37% |
| Aetna | EBR ASO | $254.40 | ↓ -33% |
| Cigna | Commercial | $254.40 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $292.46 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $318.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $349.80 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $380.18 | ↓ -0% |
| Highmark BCBS of PA | Managed Care | $391.69 | ↑ +3% |
| Coventry/First Health | Commercial | $445.20 | ↑ +17% |
| Private Health Care Systems | PPO | $508.80 | ↑ +33% |
| SelectCare | Commercial | $508.80 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity | $509.17 | ↑ +33% |
| Humana | Commercial | $540.60 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $783.37 | ↑ +105% |
Visitor-reported prices
Comments
Inj proc elbow arthro at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $666.60 | $131.35 – $944.35 |
| UPMC Mercy | Pittsburgh | $1,070.40 | $130.12 – $1,605.60 |
| UPMC Presbyterian | Pittsburgh | $777.00 | $42.00 – $1,100.75 |
| UPMC Muncy | Muncy | $969.00 | $44.80 – $1,292.00 |
| UPMC Northwest | Seneca | $450.00 | $160.65 – $637.50 |
| UPMC Somerset | Somerset | $461.40 | $40.25 – $576.75 |
| UPMC Wellsboro | Wellsboro | $1,172.00 | $44.80 – $1,318.50 |
| UPMC Williamsport | Williamsport | $969.00 | $44.80 – $1,292.00 |