healthcosts.net
Mopath procedure level 9 at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$1,947.00
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.
$3,245.00
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.
$155.23 with Aetna vs $11,974.00 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 | $155.23 | ↓ -92% |
| Aetna | Home Depot Employer Group | $168.78 | ↓ -91% |
| Aetna | NBR ASO/FI | $172.48 | ↓ -91% |
| Cigna | New Business ASO | $172.48 | ↓ -91% |
| Aetna | EBR FI | $234.08 | ↓ -88% |
| Aetna | EBR ASO | $246.40 | ↓ -87% |
| Cigna | Commercial | $246.40 | ↓ -87% |
| PA Health & Wellness | PA Medicaid HMO | $338.80 | ↓ -83% |
| Coventry/First Health | Commercial | $431.20 | ↓ -78% |
| Private Health Care Systems | PPO | $492.80 | ↓ -75% |
| SelectCare | Commercial | $492.80 | ↓ -75% |
| Humana | Commercial | $523.60 | ↓ -73% |
| UPMC Health Plan | Managed Medicare | $1,726.80 | ↓ -11% |
| UPMC Work Partners | Workers Comp | $1,976.64 | ↑ +2% |
| Aetna of PA | Medicare | $2,100.00 | ↑ +8% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,159.80 | ↑ +11% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,160.00 | ↑ +11% |
| Aetna | Medicare | $2,200.00 | ↑ +13% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $2,571.61 | ↑ +32% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,470.34 | ↑ +130% |
| UPMC Health Plan | Commercial | $4,919.38 | ↑ +153% |
| Highmark BCBS of PA | Managed Care | $5,987.00 | ↑ +207% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $7,443.08 | ↑ +282% |
| Highmark BCBS of PA | Commercial - Indemnity | $9,968.37 | ↑ +412% |
| Highmark BCBS of PA | UPMC Emergent | $11,974.00 | ↑ +515% |
Visitor-reported prices
Comments
Mopath procedure level 9 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,422.60 | $36.38 – $2,571.61 |
| UPMC Mercy | Pittsburgh | $1,947.00 | $171.86 – $2,547.36 |
| UPMC Presbyterian | Pittsburgh | $4,171.80 | $40.32 – $5,748.40 |
| UPMC Muncy | Muncy | $1,819.20 | $454.80 – $2,425.60 |
| UPMC Northwest | Seneca | $3,327.60 | $246.40 – $2,160.00 |
| UPMC Wellsboro | Wellsboro | $4,626.40 | $545.76 – $2,728.80 |
| UPMC Williamsport | Williamsport | $4,017.00 | $1,203.55 – $2,547.20 |