healthcosts.net
Mopath procedure level 5 at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,734.80
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.
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What you pay up front if you don't use insurance.
$4,558.00
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.
$177.12 with UPMC Health Plan vs $2,227.16 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 | Commercial | $177.12 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $237.29 | ↓ -91% |
| Aetna | Neighborhood Network | $266.11 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $271.62 | ↓ -90% |
| Aetna of PA | Medicare | $288.57 | ↓ -89% |
| Aetna | Home Depot Employer Group | $289.34 | ↓ -89% |
| Aetna | NBR ASO/FI | $295.68 | ↓ -89% |
| Cigna | New Business ASO | $295.68 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicare | $296.79 | ↓ -89% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $296.82 | ↓ -89% |
| Aetna | Medicare | $302.31 | ↓ -89% |
| Aetna | EBR FI | $401.28 | ↓ -85% |
| Aetna | EBR ASO | $422.40 | ↓ -85% |
| Cigna | Commercial | $422.40 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $478.32 | ↓ -83% |
| PA Health & Wellness | PA Medicaid HMO | $580.80 | ↓ -79% |
| Coventry/First Health | Commercial | $739.20 | ↓ -73% |
| Highmark BCBS of PA | Managed Care - Social Mission | $831.48 | ↓ -70% |
| Private Health Care Systems | PPO | $844.80 | ↓ -69% |
| SelectCare | Commercial | $844.80 | ↓ -69% |
| Humana | Commercial | $897.60 | ↓ -67% |
| Highmark BCBS of PA | Managed Care | $1,113.58 | ↓ -59% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,384.41 | ↓ -49% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,854.12 | ↓ -32% |
| Highmark BCBS of PA | UPMC Emergent | $2,227.16 | ↓ -19% |
Visitor-reported prices
Comments
Mopath procedure level 5 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $9,075.60 | $176.69 – $511.70 |
| UPMC Mercy | Pittsburgh | $2,734.80 | $175.65 – $863.10 |
| UPMC Presbyterian | Pittsburgh | $8,296.20 | $40.32 – $478.32 |
| UPMC Muncy | Muncy | $5,040.00 | $214.59 – $2,059.20 |
| UPMC Northwest | Seneca | $3,109.80 | $176.77 – $2,105.45 |
| UPMC Wellsboro | Wellsboro | $6,400.00 | $214.59 – $2,103.30 |
| UPMC Williamsport | Williamsport | $3,033.60 | $214.59 – $633.60 |