healthcosts.net
Resp virus 6-11 targets at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$951.60
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.
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What you pay up front if you don't use insurance.
$1,586.00
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.
$187.56 with UPMC Health Plan vs $1,348.10 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 | Commercial | $187.56 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $188.27 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $215.52 | ↓ -77% |
| Aetna of PA | Medicare | $228.96 | ↓ -76% |
| Highmark Wholecare (prev Gateway) | Medicare | $235.48 | ↓ -75% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $235.50 | ↓ -75% |
| Aetna | Medicare | $239.87 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $252.52 | ↓ -73% |
| UPMC Health Plan | Managed Medicaid | $258.17 | ↓ -73% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $258.17 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicaid | $348.06 | ↓ -63% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $366.39 | ↓ -61% |
| Aetna | Neighborhood Network | $399.67 | ↓ -58% |
| PA Health & Wellness | PA Medicaid HMO | $399.98 | ↓ -58% |
| Aetna | Home Depot Employer Group | $434.56 | ↓ -54% |
| Highmark BCBS of PA | Managed Care - Social Mission | $438.97 | ↓ -54% |
| Aetna | NBR ASO/FI | $444.08 | ↓ -53% |
| Cigna | New Business ASO | $444.08 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $587.90 | ↓ -38% |
| Aetna | EBR FI | $602.68 | ↓ -37% |
| Aetna | EBR ASO | $634.40 | ↓ -33% |
| Cigna | Commercial | $634.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $730.88 | ↓ -23% |
| Highmark BCBS of PA | Commercial - Indemnity | $978.85 | ↑ +3% |
| Coventry/First Health | Commercial | $1,110.20 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $1,175.79 | ↑ +24% |
| Private Health Care Systems | PPO | $1,268.80 | ↑ +33% |
| SelectCare | Commercial | $1,268.80 | ↑ +33% |
| Humana | Commercial | $1,348.10 | ↑ +42% |
Visitor-reported prices
Comments
Resp virus 6-11 targets at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $918.00 | $181.77 – $1,377.00 |
| UPMC Passavant-McCandless | Pittsburgh | $1,146.60 | $187.10 – $1,624.35 |
| UPMC Presbyterian | Pittsburgh | $910.20 | $197.42 – $1,289.45 |
| UPMC Northwest | Seneca | $1,575.00 | $187.18 – $2,231.25 |
| UPMC Somerset | Somerset | $1,212.60 | $215.52 – $1,515.75 |
| UPMC Wellsboro | Wellsboro | $1,237.80 | $215.52 – $1,856.70 |
| UPMC Williamsport | Williamsport | $1,237.80 | $215.52 – $1,650.40 |