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Ph body fluid at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$45.00
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.
$75.00
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.
$2.20 with UPMC Health Plan vs $60.35 with Humana — 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 | $2.20 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $2.20 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2.97 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $3.09 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $3.12 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $3.41 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $3.54 | ↓ -92% |
| Aetna of PA | Medicare | $3.76 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $3.87 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3.87 | ↓ -91% |
| Aetna | Medicare | $3.94 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $7.07 | ↓ -84% |
| UPMC Health Plan | Commercial | $7.45 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $12.30 | ↓ -73% |
| Highmark BCBS of PA | Managed Care | $16.47 | ↓ -63% |
| Aetna | Neighborhood Network | $17.89 | ↓ -60% |
| Aetna | Home Depot Employer Group | $19.45 | ↓ -57% |
| Aetna | NBR ASO/FI | $19.88 | ↓ -56% |
| Cigna | New Business ASO | $19.88 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $20.48 | ↓ -54% |
| Aetna | EBR FI | $26.98 | ↓ -40% |
| Highmark BCBS of PA | Commercial - Indemnity | $27.42 | ↓ -39% |
| Aetna | EBR ASO | $28.40 | ↓ -37% |
| Cigna | Commercial | $28.40 | ↓ -37% |
| Highmark BCBS of PA | UPMC Emergent | $32.94 | ↓ -27% |
| Coventry/First Health | Commercial | $49.70 | ↑ +10% |
| Private Health Care Systems | PPO | $56.80 | ↑ +26% |
| SelectCare | Commercial | $56.80 | ↑ +26% |
| Humana | Commercial | $60.35 | ↑ +34% |
Visitor-reported prices
Comments
Ph body fluid at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $67.80 | $2.20 – $96.05 |
| UPMC Mercy | Pittsburgh | $87.60 | $2.20 – $131.40 |
| UPMC Presbyterian | Pittsburgh | $34.20 | $2.00 – $48.45 |
| UPMC Muncy | Muncy | $39.60 | $2.20 – $52.80 |
| UPMC Northwest | Seneca | $27.00 | $2.20 – $38.25 |
| UPMC Somerset | Somerset | $19.20 | $2.00 – $14.25 |
| UPMC Wellsboro | Wellsboro | $63.20 | $2.00 – $53.77 |
| UPMC Williamsport | Williamsport | $39.60 | $2.20 – $52.80 |