healthcosts.net
Mitomycin 40 mg intravenous solution at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$866.40
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.
$3,159.90
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.
$12.85 with UPMC Health Plan vs $1,324.98 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $12.85 | ↓ -99% |
| UPMC Health Plan | Managed Medicare | $17.57 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $20.35 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $20.35 | ↓ -98% |
| Aetna of PA | Medicare | $21.37 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicare | $21.98 | ↓ -97% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $21.98 | ↓ -97% |
| Aetna | Medicare | $22.39 | ↓ -97% |
| UPMC Health Plan | Commercial | $25.03 | ↓ -97% |
| Aetna | Neighborhood Network | $40.04 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $41.04 | ↓ -95% |
| Aetna | Home Depot Employer Group | $43.53 | ↓ -95% |
| Aetna | NBR ASO/FI | $44.49 | ↓ -95% |
| Cigna | New Business ASO | $44.49 | ↓ -95% |
| Aetna | EBR FI | $60.37 | ↓ -93% |
| Aetna | EBR ASO | $63.55 | ↓ -93% |
| Cigna | Commercial | $63.55 | ↓ -93% |
| Coventry/First Health | Commercial | $111.22 | ↓ -87% |
| Private Health Care Systems | PPO | $127.10 | ↓ -85% |
| SelectCare | Commercial | $127.10 | ↓ -85% |
| Humana | Commercial | $135.05 | ↓ -84% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $313.32 | ↓ -64% |
| Highmark BCBS of PA | Managed Care - Social Mission | $494.69 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $497.23 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $662.49 | ↓ -24% |
| Highmark BCBS of PA | Commercial - Indemnity | $665.93 | ↓ -23% |
| Highmark BCBS of PA | UPMC Emergent | $1,324.98 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Mitomycin 40 mg intravenous solution at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $596.00 | $12.85 – $310.36 |
| UPMC Passavant-McCandless | Pittsburgh | $6,847.80 | $12.85 – $2,424.20 |
| UPMC Presbyterian | Pittsburgh | $1,714.80 | $12.85 – $2,429.30 |
| UPMC Western Psychiatric | Pittsburgh | $1,714.80 | $20.35 – $2,429.30 |
| UPMC Muncy | Muncy | $3,278.40 | $20.35 – $241.20 |
| UPMC Northwest | Seneca | $1,169.60 | $12.85 – $135.05 |
| UPMC Somerset | Somerset | $758.40 | $3.70 – $20.35 |
| UPMC Wellsboro | Wellsboro | $3,278.40 | $20.35 – $241.20 |