healthcosts.net
Mr sfty med physics xm cstmz at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$444.00
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.
?
What you pay up front if you don't use insurance.
$740.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$135.66 with Highmark BCBS of PA vs $629.00 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Highmark BCBS of PA | Managed Care - Social Mission | $135.66 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $176.35 | ↓ -60% |
| Highmark BCBS of PA | Managed Care | $181.69 | ↓ -59% |
| Aetna | Medicare | $185.00 | ↓ -58% |
| Aetna | Neighborhood Network | $186.48 | ↓ -58% |
| UPMC Health Plan | Managed Medicare | $198.97 | ↓ -55% |
| UPMC Work Partners | Workers Comp | $199.31 | ↓ -55% |
| Aetna | Home Depot Employer Group | $202.76 | ↓ -54% |
| Aetna | NBR ASO/FI | $207.20 | ↓ -53% |
| Cigna | New Business ASO | $207.20 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $236.18 | ↓ -47% |
| Aetna of PA | Medicare | $241.97 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicare | $248.86 | ↓ -44% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $248.89 | ↓ -44% |
| Aetna | EBR FI | $281.20 | ↓ -37% |
| Aetna | EBR ASO | $296.00 | ↓ -33% |
| Cigna | Commercial | $296.00 | ↓ -33% |
| UPMC Health Plan | Commercial | $362.97 | ↓ -18% |
| Highmark BCBS of PA | UPMC Emergent | $363.37 | ↓ -18% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $370.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $407.00 | ↓ -8% |
| Coventry/First Health | Commercial | $518.00 | ↑ +17% |
| Private Health Care Systems | PPO | $592.00 | ↑ +33% |
| SelectCare | Commercial | $592.00 | ↑ +33% |
| Humana | Commercial | $629.00 | ↑ +42% |
Visitor-reported prices
Comments
Mr sfty med physics xm cstmz at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $444.00 | $135.66 – $629.00 |
| UPMC Mercy | Pittsburgh | $444.00 | $60.36 – $666.00 |
| UPMC Presbyterian | Pittsburgh | $591.60 | $60.93 – $838.10 |
| UPMC Muncy | Muncy | $439.80 | $109.95 – $586.40 |
| UPMC Northwest | Seneca | $444.00 | $156.65 – $629.00 |
| UPMC Somerset | Somerset | $444.00 | $59.74 – $555.00 |
| UPMC Wellsboro | Wellsboro | $439.80 | $131.94 – $659.70 |
| UPMC Williamsport | Williamsport | $439.80 | $197.91 – $586.40 |