healthcosts.net
Transcatheter bx s&i at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$2,236.20
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.
$3,727.00
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.
$19.25 with UPMC Health Plan vs $3,259.27 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $19.25 | ↓ -99% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $19.25 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $25.95 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $27.32 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $29.82 | ↓ -99% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $546.51 | ↓ -76% |
| UPMC Health Plan | Commercial | $816.04 | ↓ -64% |
| Aetna | Medicare | $931.75 | ↓ -58% |
| Aetna | Neighborhood Network | $939.20 | ↓ -58% |
| Aetna | Home Depot Employer Group | $1,021.20 | ↓ -54% |
| Aetna | NBR ASO/FI | $1,043.56 | ↓ -53% |
| Cigna | New Business ASO | $1,043.56 | ↓ -53% |
| UPMC Work Partners | Workers Comp | $1,174.76 | ↓ -47% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,216.80 | ↓ -46% |
| Aetna | EBR FI | $1,416.26 | ↓ -37% |
| Aetna | EBR ASO | $1,490.80 | ↓ -33% |
| Cigna | Commercial | $1,490.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,581.78 | ↓ -29% |
| Highmark BCBS of PA | Managed Care | $1,629.63 | ↓ -27% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,863.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,118.45 | ↓ -5% |
| Coventry/First Health | Commercial | $2,608.90 | ↑ +17% |
| Private Health Care Systems | PPO | $2,981.60 | ↑ +33% |
| SelectCare | Commercial | $2,981.60 | ↑ +33% |
| Humana | Commercial | $3,167.95 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $3,259.27 | ↑ +46% |
Visitor-reported prices
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Transcatheter bx s&i at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $3,277.20 | $19.25 – $4,642.70 |
| UPMC Mercy | Pittsburgh | $2,360.40 | $19.25 – $3,540.60 |
| UPMC Presbyterian | Pittsburgh | $2,866.20 | $12.00 – $4,060.45 |
| UPMC Somerset | Somerset | $6,169.80 | $11.50 – $7,712.25 |
| UPMC Williamsport | Williamsport | $2,803.80 | $12.80 – $3,738.40 |