healthcosts.net
Cltx carpl scphd fx w/mnpj at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$3,769.20
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.
?
What you pay up front if you don't use insurance.
$6,282.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$170.50 with UPMC Health Plan vs $5,339.70 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $170.50 | ↓ -95% |
| United Healthcare Community Plan for Families | Unison Kids | $178.25 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $229.87 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $241.97 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $264.15 | ↓ -93% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $866.26 | ↓ -77% |
| Private Health Care Systems | Workers' Comp | $1,007.28 | ↓ -73% |
| UPMC Health Plan | Commercial | $1,039.31 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $1,417.93 | ↓ -62% |
| Health Plan of Upper Ohio Valley | Medicare | $1,525.80 | ↓ -60% |
| Health Plan of Upper Ohio Valley | Medicaid | $1,525.80 | ↓ -60% |
| United Healthcare | Unison Advantage Non Special Needs | $1,602.09 | ↓ -57% |
| Aetna of PA | Medicare | $1,602.09 | ↓ -57% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,640.37 | ↓ -56% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,647.71 | ↓ -56% |
| AmeriHealth Caritas | Medicare | $1,647.86 | ↓ -56% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,647.86 | ↓ -56% |
| Aetna | Medicare | $1,678.38 | ↓ -55% |
| United Healthcare | Unison Advantage Special Needs | $1,678.38 | ↓ -55% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,044.88 | ↓ -46% |
| Cigna | New Business ASO | $2,135.88 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $2,196.91 | ↓ -42% |
| Cigna | Commercial | $2,512.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,738.68 | ↓ -27% |
| Health Plan of Upper Ohio Valley | Commercial | $2,902.28 | ↓ -23% |
| Highmark BCBS of PA | UPMC Emergent | $4,393.81 | ↑ +17% |
| Coventry/First Health | Commercial | $4,397.40 | ↑ +17% |
| InterGroup | PPO | $5,214.06 | ↑ +38% |
| Private Health Care Systems | PPO | $5,339.70 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $5,339.70 | ↑ +42% |
| Humana | Commercial | $5,339.70 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Cltx carpl scphd fx w/mnpj at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $5,289.00 | $170.50 – $7,492.75 |
| UPMC Muncy | Muncy | $3,184.20 | $170.50 – $4,245.60 |
| UPMC Somerset | Somerset | $2,440.80 | $170.50 – $3,051.00 |
| UPMC Williamsport | Williamsport | $4,493.40 | $170.50 – $5,991.20 |