healthcosts.net
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$186.60
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.
$311.00
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.
$10.78 with UPMC Health Plan vs $264.35 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 | Managed Medicaid | $10.78 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $10.78 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.53 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.30 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $16.70 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $19.54 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $22.99 | ↓ -88% |
| Highmark BCBS of PA | Managed Care - Social Mission | $60.04 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $66.53 | ↓ -64% |
| Aetna | Medicare | $77.75 | ↓ -58% |
| Aetna | Neighborhood Network | $78.37 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $80.42 | ↓ -57% |
| Aetna | Home Depot Employer Group | $85.21 | ↓ -54% |
| Aetna | NBR ASO/FI | $87.08 | ↓ -53% |
| Cigna | New Business ASO | $87.08 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity | $89.11 | ↓ -52% |
| UPMC Health Plan | Commercial | $90.57 | ↓ -51% |
| Aetna | EBR FI | $118.18 | ↓ -37% |
| Aetna | EBR ASO | $124.40 | ↓ -33% |
| Cigna | Commercial | $124.40 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $155.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $160.83 | ↓ -14% |
| Coventry/First Health | Commercial | $217.70 | ↑ +17% |
| Private Health Care Systems | PPO | $248.80 | ↑ +33% |
| SelectCare | Commercial | $248.80 | ↑ +33% |
| Humana | Commercial | $264.35 | ↑ +42% |
Visitor-reported prices
Comments
Treatment inhalation continuous aerosol medication acute airway obstruction each additional hour at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $272.40 | $10.78 – $408.60 |
| UPMC Passavant-McCandless | Pittsburgh | $91.20 | $10.78 – $129.20 |
| UPMC Presbyterian | Pittsburgh | $197.40 | $10.78 – $279.65 |
| UPMC Muncy | Muncy | $234.00 | $10.78 – $312.00 |
| UPMC Somerset | Somerset | $424.80 | $10.78 – $531.00 |
| UPMC Wellsboro | Wellsboro | $282.40 | $10.78 – $317.70 |
| UPMC Williamsport | Williamsport | $234.00 | $10.78 – $312.00 |