healthcosts.net
Prothrombin time substitution plasma fractions each at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$66.60
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.
$111.00
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.
$3.40 with UPMC Health Plan vs $94.35 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 | $3.40 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $3.90 | ↓ -94% |
| Aetna of PA | Medicare | $4.14 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $4.25 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4.26 | ↓ -94% |
| Aetna | Medicare | $4.33 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $5.97 | ↓ -91% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $5.97 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $8.05 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $8.48 | ↓ -87% |
| PA Health & Wellness | PA Medicaid HMO | $9.25 | ↓ -86% |
| UPMC Health Plan | Commercial | $10.30 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $10.81 | ↓ -84% |
| Highmark BCBS of PA | Managed Care - Social Mission | $18.79 | ↓ -72% |
| Highmark BCBS of PA | Managed Care | $25.16 | ↓ -62% |
| Aetna | Neighborhood Network | $27.97 | ↓ -58% |
| Aetna | Home Depot Employer Group | $30.41 | ↓ -54% |
| Aetna | NBR ASO/FI | $31.08 | ↓ -53% |
| Cigna | New Business ASO | $31.08 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $31.28 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $41.90 | ↓ -37% |
| Aetna | EBR FI | $42.18 | ↓ -37% |
| Aetna | EBR ASO | $44.40 | ↓ -33% |
| Cigna | Commercial | $44.40 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $50.33 | ↓ -24% |
| Coventry/First Health | Commercial | $77.70 | ↑ +17% |
| Private Health Care Systems | PPO | $88.80 | ↑ +33% |
| SelectCare | Commercial | $88.80 | ↑ +33% |
| Humana | Commercial | $94.35 | ↑ +42% |
Visitor-reported prices
Comments
Prothrombin time substitution plasma fractions each at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $96.00 | $3.66 – $120.70 |
| UPMC Mercy | Pittsburgh | $41.40 | $3.28 – $62.10 |
| UPMC Presbyterian | Pittsburgh | $590.40 | $3.90 – $836.40 |
| UPMC Muncy | Muncy | $190.20 | $3.90 – $253.60 |
| UPMC Northwest | Seneca | $60.60 | $3.57 – $85.85 |
| UPMC Somerset | Somerset | $21.00 | $3.90 – $26.25 |
| UPMC Wellsboro | Wellsboro | $230.40 | $3.90 – $259.20 |
| UPMC Williamsport | Williamsport | $190.20 | $3.90 – $253.60 |