healthcosts.net
Lipoprotein blood quant at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$285.00
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.
$475.00
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.
$29.52 with UPMC Health Plan vs $403.75 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 | $29.52 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $33.79 | ↓ -88% |
| Aetna of PA | Medicare | $35.90 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicare | $36.92 | ↓ -87% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $36.93 | ↓ -87% |
| Aetna | Medicare | $37.61 | ↓ -87% |
| UPMC Health Plan | Commercial | $50.68 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $82.72 | ↓ -71% |
| Aetna | Neighborhood Network | $119.70 | ↓ -58% |
| Aetna | Home Depot Employer Group | $130.15 | ↓ -54% |
| Aetna | NBR ASO/FI | $133.00 | ↓ -53% |
| Cigna | New Business ASO | $133.00 | ↓ -53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $143.79 | ↓ -50% |
| Aetna | EBR FI | $180.50 | ↓ -37% |
| Aetna | EBR ASO | $190.00 | ↓ -33% |
| Cigna | Commercial | $190.00 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $192.57 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $239.41 | ↓ -16% |
| PA Health & Wellness | PA Medicaid HMO | $261.25 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Indemnity | $320.63 | ↑ +13% |
| Coventry/First Health | Commercial | $332.50 | ↑ +17% |
| Private Health Care Systems | PPO | $380.00 | ↑ +33% |
| SelectCare | Commercial | $380.00 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $385.14 | ↑ +35% |
| Humana | Commercial | $403.75 | ↑ +42% |
Visitor-reported prices
Comments
Lipoprotein blood quant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $320.40 | $31.77 – $453.90 |
| UPMC Mercy | Pittsburgh | $214.80 | $28.50 – $322.20 |
| UPMC Presbyterian | Pittsburgh | $400.20 | $25.03 – $566.95 |
| UPMC Muncy | Muncy | $394.20 | $26.70 – $525.60 |
| UPMC Northwest | Seneca | $280.20 | $31.01 – $396.95 |
| UPMC Somerset | Somerset | $172.20 | $23.99 – $215.25 |
| UPMC Wellsboro | Wellsboro | $476.80 | $26.70 – $511.20 |
| UPMC Williamsport | Williamsport | $375.60 | $26.70 – $500.80 |