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Ring fx reform 11-13x17mm at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$456.60
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.
$761.00
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.
$127.40 with Highmark Wholecare (prev Gateway) vs $6,321.86 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $127.40 | ↓ -72% |
| Aetna | Medicare | $159.25 | ↓ -65% |
| Aetna | Neighborhood Network | $160.52 | ↓ -65% |
| Aetna | Home Depot Employer Group | $174.54 | ↓ -62% |
| Aetna | NBR ASO/FI | $178.36 | ↓ -61% |
| Cigna | New Business ASO | $178.36 | ↓ -61% |
| PA Health & Wellness | PA Medicaid HMO | $210.21 | ↓ -54% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $215.50 | ↓ -53% |
| Aetna | EBR FI | $242.06 | ↓ -47% |
| Aetna | EBR ASO | $254.80 | ↓ -44% |
| Cigna | Commercial | $254.80 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicare | $318.50 | ↓ -30% |
| Coventry/First Health | Commercial | $445.90 | ↓ -2% |
| Private Health Care Systems | PPO | $509.60 | ↑ +12% |
| SelectCare | Commercial | $509.60 | ↑ +12% |
| Humana | Commercial | $541.45 | ↑ +19% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $819.67 | ↑ +80% |
| UPMC Health Plan | Commercial | $1,485.02 | ↑ +225% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,360.30 | ↑ +417% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,372.40 | ↑ +420% |
| Highmark BCBS of PA | Managed Care | $3,160.93 | ↑ +592% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,177.31 | ↑ +596% |
| Highmark BCBS of PA | UPMC Emergent | $6,321.86 | ↑ +1285% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Ring fx reform 11-13x17mm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,800.00 | $120.48 – $955.64 |
| UPMC Presbyterian | Pittsburgh | $3,167.40 | $63.60 – $1,956.70 |
| UPMC Muncy | Muncy | $422.40 | $98.70 – $592.20 |