healthcosts.net
Injection, fulvestrant at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$912.80
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.
?
What you pay up front if you don't use insurance.
$1,141.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$4.25 with UPMC Health Plan vs $834.94 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $4.25 | ↓ -100% |
| UPMC Health Plan | Managed Medicare | $5.81 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $6.73 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $6.73 | ↓ -99% |
| Aetna of PA | Medicare | $7.07 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $7.27 | ↓ -99% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $7.27 | ↓ -99% |
| Aetna | Medicare | $7.40 | ↓ -99% |
| UPMC Health Plan | Commercial | $8.28 | ↓ -99% |
| Aetna | Neighborhood Network | $37.68 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $38.62 | ↓ -96% |
| Aetna | Home Depot Employer Group | $40.97 | ↓ -96% |
| Aetna | NBR ASO/FI | $41.87 | ↓ -95% |
| Cigna | New Business ASO | $41.87 | ↓ -95% |
| Aetna | EBR FI | $56.82 | ↓ -94% |
| Aetna | EBR ASO | $59.81 | ↓ -93% |
| Cigna | Commercial | $59.81 | ↓ -93% |
| Coventry/First Health | Commercial | $104.67 | ↓ -89% |
| Private Health Care Systems | PPO | $119.62 | ↓ -87% |
| SelectCare | Commercial | $119.62 | ↓ -87% |
| Humana | Commercial | $127.10 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $168.34 | ↓ -82% |
| Highmark BCBS of PA | Managed Care - Social Mission | $311.73 | ↓ -66% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $313.33 | ↓ -66% |
| Highmark BCBS of PA | Managed Care | $417.47 | ↓ -54% |
| Highmark BCBS of PA | Commercial - Indemnity | $419.63 | ↓ -54% |
| Highmark BCBS of PA | UPMC Emergent | $834.94 | ↓ -9% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Injection, fulvestrant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,940.80 | $4.25 – $166.75 |
| UPMC Passavant-McCandless | Pittsburgh | $4,829.40 | $4.25 – $250.75 |
| UPMC Presbyterian | Pittsburgh | $9,219.60 | $4.25 – $1,305.60 |
| UPMC Western Psychiatric | Pittsburgh | $921.60 | $6.73 – $1,305.60 |
| UPMC Muncy | Muncy | $4,423.20 | $6.73 – $663.30 |
| UPMC Northwest | Seneca | $6,048.60 | $4.25 – $127.10 |
| UPMC Wellsboro | Wellsboro | $4,423.20 | $6.73 – $663.30 |
| UPMC Williamsport | Williamsport | $589.60 | $6.73 – $663.30 |