healthcosts.net
Tube trach disp innr can 5 xlt at UPMC St. Margaret
815 Freeport Road, Pittsburgh, PA · UPMC · · NPI 1790795359
$421.80
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.
$703.00
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.
$49.25 with Aetna vs $680.95 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 | Medicare | $49.25 | ↓ -88% |
| Aetna | Neighborhood Network | $49.64 | ↓ -88% |
| Aetna | Home Depot Employer Group | $53.98 | ↓ -87% |
| Aetna | NBR ASO/FI | $55.16 | ↓ -87% |
| Cigna | New Business ASO | $55.16 | ↓ -87% |
| Aetna | EBR FI | $74.86 | ↓ -82% |
| Aetna | EBR ASO | $78.80 | ↓ -81% |
| Cigna | Commercial | $78.80 | ↓ -81% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $88.29 | ↓ -79% |
| UPMC Work Partners | Workers Comp | $89.35 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicare | $98.50 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $108.35 | ↓ -74% |
| Coventry/First Health | Commercial | $137.90 | ↓ -67% |
| Private Health Care Systems | PPO | $157.60 | ↓ -63% |
| SelectCare | Commercial | $157.60 | ↓ -63% |
| Humana | Commercial | $167.45 | ↓ -60% |
| Highmark BCBS of PA | Managed Care - Social Mission | $254.23 | ↓ -40% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $255.54 | ↓ -39% |
| UPMC Health Plan | Commercial | $322.90 | ↓ -23% |
| Highmark BCBS of PA | Managed Care | $340.47 | ↓ -19% |
| Highmark BCBS of PA | Commercial - Indemnity | $342.24 | ↓ -19% |
| Highmark BCBS of PA | UPMC Emergent | $680.95 | ↑ +61% |
Visitor-reported prices
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Tube trach disp innr can 5 xlt at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $394.80 | $22.75 – $207.79 |
| UPMC Passavant-McCandless | Pittsburgh | $775.20 | $49.25 – $381.85 |
| UPMC Presbyterian | Pittsburgh | $4,183.80 | $1.08 – $425.46 |
| UPMC Muncy | Muncy | $220.80 | $23.25 – $124.00 |
| UPMC Northwest | Seneca | $141.00 | $31.00 – $318.43 |
| UPMC Wellsboro | Wellsboro | $266.40 | $25.38 – $126.90 |
| UPMC Williamsport | Williamsport | $220.80 | $35.10 – $104.00 |