healthcosts.net
5' nucleotidase - sendout at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$58.80
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.
$98.00
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.
$10.36 with UPMC Health Plan vs $101.25 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 Medicare | $10.36 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $11.02 | ↓ -81% |
| Health Plan of Upper Ohio Valley | Medicaid | $11.15 | ↓ -81% |
| Health Plan of Upper Ohio Valley | Medicare | $11.15 | ↓ -81% |
| Aetna of PA | Medicare | $11.71 | ↓ -80% |
| United Healthcare | Unison Advantage Non Special Needs | $11.71 | ↓ -80% |
| AmeriHealth Caritas | Medicare | $12.04 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.04 | ↓ -80% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12.04 | ↓ -80% |
| Aetna | Medicare | $12.27 | ↓ -79% |
| United Healthcare | Unison Advantage Special Needs | $12.27 | ↓ -79% |
| Private Health Care Systems | Workers' Comp | $12.81 | ↓ -78% |
| UPMC Health Plan | Managed Medicaid | $16.95 | ↓ -71% |
| United Healthcare Community Plan for Families | Unison Kids | $17.72 | ↓ -70% |
| UPMC Health Plan | Commercial | $19.64 | ↓ -67% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $21.77 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicaid | $22.85 | ↓ -61% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $24.06 | ↓ -59% |
| PA Health & Wellness | PA Medicaid HMO | $26.26 | ↓ -55% |
| Cigna | New Business ASO | $33.32 | ↓ -43% |
| Highmark BCBS of PA | Managed Care - Social Mission | $37.80 | ↓ -36% |
| Cigna | Commercial | $39.20 | ↓ -33% |
| Health Plan of Upper Ohio Valley | Commercial | $45.28 | ↓ -23% |
| Highmark BCBS of PA | Managed Care | $50.63 | ↓ -14% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $60.42 | ↑ +3% |
| Coventry/First Health | Commercial | $68.60 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $80.91 | ↑ +38% |
| InterGroup | PPO | $81.34 | ↑ +38% |
| Humana | Commercial | $83.30 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $83.30 | ↑ +42% |
| Private Health Care Systems | PPO | $83.30 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $101.25 | ↑ +72% |
Visitor-reported prices
Comments
5' nucleotidase - sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $223.20 | $9.29 – $334.80 |
| UPMC Presbyterian | Pittsburgh | $455.40 | $11.02 – $645.15 |
| UPMC St. Margaret | Pittsburgh | $80.40 | $9.63 – $113.90 |
| UPMC Muncy | Muncy | $243.00 | $11.02 – $324.00 |
| UPMC Northwest | Seneca | $58.80 | $10.11 – $83.30 |
| UPMC Somerset | Somerset | $56.40 | $11.02 – $70.50 |
| UPMC Wellsboro | Wellsboro | $294.40 | $11.02 – $331.20 |
| UPMC Williamsport | Williamsport | $243.00 | $11.02 – $324.00 |