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Lower Back (Lumbar Spine) MRI (with and without contrast) at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$5,810.40
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.
$9,684.00
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.
$293.97 with UPMC Health Plan vs $8,231.40 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicare | $293.97 | ↓ -95% |
| Aetna of PA | Medicare | $357.50 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $367.68 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $367.72 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $372.90 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $372.90 | ↓ -94% |
| Aetna | Medicare | $374.53 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $502.74 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $529.21 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $577.72 | ↓ -90% |
| UPMC Health Plan | Commercial | $1,055.70 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,214.10 | ↓ -79% |
| Premier Comp Solutions | Worker's Comp | $2,428.73 | ↓ -58% |
| Aetna | Neighborhood Network | $2,440.37 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $2,610.88 | ↓ -55% |
| Aetna | Home Depot Employer Group | $2,653.42 | ↓ -54% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,703.17 | ↓ -53% |
| Aetna | NBR ASO/FI | $2,711.52 | ↓ -53% |
| Cigna | New Business ASO | $2,711.52 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,513.99 | ↓ -40% |
| Highmark BCBS of PA | Managed Care | $3,620.29 | ↓ -38% |
| Aetna | EBR FI | $3,679.92 | ↓ -37% |
| Aetna | EBR ASO | $3,873.60 | ↓ -33% |
| Cigna | Commercial | $3,873.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,706.21 | ↓ -19% |
| Coventry/First Health | Commercial | $6,778.80 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $7,240.58 | ↑ +25% |
| Private Health Care Systems | PPO | $7,747.20 | ↑ +33% |
| SelectCare | Commercial | $7,747.20 | ↑ +33% |
| Humana | Commercial | $8,231.40 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (with and without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,999.40 | $316.41 – $8,499.15 |
| UPMC Magee | Pittsburgh | $6,741.00 | $318.66 – $10,336.20 |
| UPMC Mercy | Pittsburgh | $6,512.40 | $283.82 – $9,768.60 |
| UPMC Presbyterian | Pittsburgh | $9,808.20 | $322.80 – $13,894.95 |
| UPMC East | Monroeville | $6,218.40 | $341.40 – $8,291.20 |
| UPMC Hamot | Erie | $2,536.20 | $281.64 – $2,958.90 |
| UPMC Carlisle | Carlisle | $2,713.80 | $338.22 – $3,844.55 |
| UPMC Bedford | Everett | $2,884.20 | $122.85 – $4,326.30 |