healthcosts.net
Phleb veins 1 extrm 10-20 stab at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$4,651.80
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.
?
What you pay up front if you don't use insurance.
$7,753.00
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.
$846.89 with UPMC Work Partners vs $6,590.05 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $846.89 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $850.45 | ↓ -82% |
| UPMC Health Plan | Commercial | $1,523.79 | ↓ -67% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,893.51 | ↓ -59% |
| Aetna | Neighborhood Network | $1,953.76 | ↓ -58% |
| Aetna | Home Depot Employer Group | $2,124.32 | ↓ -54% |
| Aetna | NBR ASO/FI | $2,170.84 | ↓ -53% |
| Cigna | New Business ASO | $2,170.84 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,461.47 | ↓ -47% |
| Highmark BCBS of PA | Managed Care | $2,535.94 | ↓ -45% |
| UPMC Health Plan | Managed Medicare | $2,590.86 | ↓ -44% |
| Aetna | EBR FI | $2,946.14 | ↓ -37% |
| Aetna | EBR ASO | $3,101.20 | ↓ -33% |
| Cigna | Commercial | $3,101.20 | ↓ -33% |
| Aetna of PA | Medicare | $3,150.80 | ↓ -32% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,240.52 | ↓ -30% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,240.82 | ↓ -30% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,296.60 | ↓ -29% |
| Aetna | Medicare | $3,300.84 | ↓ -29% |
| PA Health & Wellness | PA Medicaid HMO | $4,264.15 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $5,071.87 | ↑ +9% |
| Coventry/First Health | Commercial | $5,427.10 | ↑ +17% |
| Private Health Care Systems | PPO | $6,202.40 | ↑ +33% |
| SelectCare | Commercial | $6,202.40 | ↑ +33% |
| Humana | Commercial | $6,590.05 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Phleb veins 1 extrm 10-20 stab at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $4,579.20 | $850.45 – $6,487.20 |
| UPMC Mercy | Pittsburgh | not published | $842.43 – $3,300.84 |
| UPMC Somerset | Somerset | $8,640.60 | $833.91 – $10,800.75 |
| UPMC Northwest | Seneca | not published | $846.89 – $3,240.82 |