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Tc-99m exametazime diag at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$1,461.00
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.
$2,435.00
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.
$613.62 with Aetna vs $12,889.91 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 |
|---|---|---|---|
| Aetna | Neighborhood Network | $613.62 | ↓ -58% |
| Aetna | Home Depot Employer Group | $667.19 | ↓ -54% |
| Aetna | NBR ASO/FI | $681.80 | ↓ -53% |
| Cigna | New Business ASO | $681.80 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $692.74 | ↓ -53% |
| Aetna of PA | Medicare | $842.46 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicare | $866.45 | ↓ -41% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $866.53 | ↓ -41% |
| Aetna | Medicare | $882.57 | ↓ -40% |
| Aetna | EBR FI | $925.30 | ↓ -37% |
| Aetna | EBR ASO | $974.00 | ↓ -33% |
| Cigna | Commercial | $974.00 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $1,339.25 | ↓ -8% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,671.27 | ↑ +14% |
| Coventry/First Health | Commercial | $1,704.50 | ↑ +17% |
| Private Health Care Systems | PPO | $1,948.00 | ↑ +33% |
| SelectCare | Commercial | $1,948.00 | ↑ +33% |
| Humana | Commercial | $2,069.75 | ↑ +42% |
| UPMC Health Plan | Commercial | $4,013.29 | ↑ +175% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,812.52 | ↑ +229% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,837.19 | ↑ +231% |
| Highmark BCBS of PA | Managed Care | $6,444.95 | ↑ +341% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,478.35 | ↑ +343% |
| Highmark BCBS of PA | UPMC Emergent | $12,889.91 | ↑ +782% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Tc-99m exametazime diag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,733.20 | $745.61 – $5,288.70 |
| UPMC Presbyterian | Pittsburgh | $8,173.20 | $866.53 – $11,578.70 |
| UPMC Northwest | Seneca | $1,750.20 | $727.64 – $2,479.45 |
| UPMC Wellsboro | Wellsboro | $867.20 | $195.12 – $975.60 |
| UPMC Williamsport | Williamsport | $717.00 | $475.49 – $1,075.50 |