healthcosts.net
Intro long gi tube w/mult fluo at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$780.60
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.
$1,301.00
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.
$147.61 with Highmark BCBS of PA vs $1,105.85 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 | $147.61 | ↓ -81% |
| UPMC Health Plan | Commercial | $223.36 | ↓ -71% |
| UPMC Work Partners | Workers Comp | $317.82 | ↓ -59% |
| Aetna | Medicare | $325.25 | ↓ -58% |
| Aetna | Neighborhood Network | $327.85 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $328.64 | ↓ -58% |
| Aetna | Home Depot Employer Group | $356.47 | ↓ -54% |
| Aetna | NBR ASO/FI | $364.28 | ↓ -53% |
| Cigna | New Business ASO | $364.28 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $427.22 | ↓ -45% |
| Highmark BCBS of PA | Managed Care | $440.14 | ↓ -44% |
| Aetna | EBR FI | $494.38 | ↓ -37% |
| Aetna | EBR ASO | $520.40 | ↓ -33% |
| Cigna | Commercial | $520.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $572.16 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $650.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $715.55 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $880.28 | ↑ +13% |
| Coventry/First Health | Commercial | $910.70 | ↑ +17% |
| Private Health Care Systems | PPO | $1,040.80 | ↑ +33% |
| SelectCare | Commercial | $1,040.80 | ↑ +33% |
| Humana | Commercial | $1,105.85 | ↑ +42% |
Visitor-reported prices
Comments
Intro long gi tube w/mult fluo at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $761.40 | $147.61 – $1,078.65 |
| UPMC Mercy | Pittsburgh | $721.20 | $146.21 – $1,081.80 |
| UPMC Presbyterian | Pittsburgh | $1,226.40 | $147.61 – $1,737.40 |
| UPMC Muncy | Muncy | $384.60 | $96.15 – $512.80 |
| UPMC Somerset | Somerset | $423.60 | $144.73 – $529.50 |
| UPMC Wellsboro | Wellsboro | $464.80 | $104.58 – $522.90 |
| UPMC Williamsport | Williamsport | $384.60 | $173.07 – $512.80 |