healthcosts.net
Mopath procedure level 8 at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$1,687.80
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.
$2,813.00
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.
$253.76 with Aetna vs $8,920.62 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 |
|---|---|---|---|
| Aetna | Neighborhood Network | $253.76 | ↓ -85% |
| Aetna | Home Depot Employer Group | $275.92 | ↓ -84% |
| Aetna | NBR ASO/FI | $281.96 | ↓ -83% |
| Cigna | New Business ASO | $281.96 | ↓ -83% |
| Aetna | EBR FI | $382.66 | ↓ -77% |
| Aetna | EBR ASO | $402.80 | ↓ -76% |
| Cigna | Commercial | $402.80 | ↓ -76% |
| PA Health & Wellness | PA Medicaid HMO | $553.85 | ↓ -67% |
| Coventry/First Health | Commercial | $704.90 | ↓ -58% |
| UPMC Health Plan | Managed Medicare | $730.67 | ↓ -57% |
| Private Health Care Systems | PPO | $805.60 | ↓ -52% |
| SelectCare | Commercial | $805.60 | ↓ -52% |
| UPMC Work Partners | Workers Comp | $836.39 | ↓ -50% |
| UPMC Health Plan | Commercial | $840.33 | ↓ -50% |
| Humana | Commercial | $855.95 | ↓ -49% |
| Aetna of PA | Medicare | $888.58 | ↓ -47% |
| Highmark Wholecare (prev Gateway) | Medicare | $913.89 | ↓ -46% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $913.97 | ↓ -46% |
| Aetna | Medicare | $930.90 | ↓ -45% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,915.85 | ↑ +14% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,330.40 | ↑ +97% |
| Highmark BCBS of PA | Managed Care | $4,460.31 | ↑ +164% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $5,545.09 | ↑ +229% |
| Highmark BCBS of PA | Commercial - Indemnity | $7,426.43 | ↑ +340% |
| Highmark BCBS of PA | UPMC Emergent | $8,920.62 | ↑ +429% |
Visitor-reported prices
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Mopath procedure level 8 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,400.80 | $786.44 – $2,232.10 |
| UPMC Mercy | Pittsburgh | $1,687.80 | $280.95 – $1,897.78 |
| UPMC Presbyterian | Pittsburgh | $1,687.80 | $60.48 – $1,915.85 |
| UPMC Muncy | Muncy | $1,792.80 | $448.20 – $2,390.40 |
| UPMC Northwest | Seneca | $1,687.80 | $402.80 – $913.97 |
| UPMC Wellsboro | Wellsboro | $2,276.80 | $458.46 – $2,292.30 |
| UPMC Williamsport | Williamsport | $1,672.20 | $377.24 – $913.89 |