healthcosts.net
Protein electrophoretic fractionation & quantitation serum at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$173.40
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.
$289.00
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.
$9.27 with UPMC Health Plan vs $245.65 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 Health Plan | Managed Medicare | $9.27 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $10.62 | ↓ -94% |
| Aetna of PA | Medicare | $11.28 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $11.60 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11.60 | ↓ -93% |
| Aetna | Medicare | $11.81 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $16.11 | ↓ -91% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $16.11 | ↓ -91% |
| UPMC Health Plan | Commercial | $18.60 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $20.98 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $21.73 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $22.87 | ↓ -87% |
| PA Health & Wellness | PA Medicaid HMO | $24.97 | ↓ -86% |
| Highmark BCBS of PA | Managed Care - Social Mission | $36.47 | ↓ -79% |
| Highmark BCBS of PA | Managed Care | $48.84 | ↓ -72% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $60.72 | ↓ -65% |
| Aetna | Neighborhood Network | $72.83 | ↓ -58% |
| Aetna | Home Depot Employer Group | $79.19 | ↓ -54% |
| Aetna | NBR ASO/FI | $80.92 | ↓ -53% |
| Cigna | New Business ASO | $80.92 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $81.32 | ↓ -53% |
| Highmark BCBS of PA | UPMC Emergent | $97.68 | ↓ -44% |
| Aetna | EBR FI | $109.82 | ↓ -37% |
| Aetna | EBR ASO | $115.60 | ↓ -33% |
| Cigna | Commercial | $115.60 | ↓ -33% |
| Coventry/First Health | Commercial | $202.30 | ↑ +17% |
| Private Health Care Systems | PPO | $231.20 | ↑ +33% |
| SelectCare | Commercial | $231.20 | ↑ +33% |
| Humana | Commercial | $245.65 | ↑ +42% |
Visitor-reported prices
Comments
Protein electrophoretic fractionation & quantitation serum at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $235.20 | $9.98 – $333.20 |
| UPMC Mercy | Pittsburgh | $119.40 | $8.95 – $179.10 |
| UPMC Presbyterian | Pittsburgh | $1,228.80 | $10.62 – $1,740.80 |
| UPMC Muncy | Muncy | $171.60 | $10.62 – $228.80 |
| UPMC Northwest | Seneca | $241.20 | $9.74 – $341.70 |
| UPMC Somerset | Somerset | $61.20 | $10.62 – $68.25 |
| UPMC Wellsboro | Wellsboro | $207.20 | $10.62 – $233.10 |
| UPMC Williamsport | Williamsport | $171.60 | $10.62 – $228.80 |