healthcosts.net
Complx repair enel addl 5cm/< 13153 at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$1,606.80
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.
?
What you pay up front if you don't use insurance.
$2,678.00
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.
$287.80 with UPMC Work Partners vs $2,276.30 with Private Health Care Systems — 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 Work Partners | Workers Comp | $287.80 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $309.30 | ↓ -81% |
| Private Health Care Systems | Workers' Comp | $334.65 | ↓ -79% |
| UPMC Health Plan | Commercial | $355.99 | ↓ -78% |
| Aetna | Medicare | $669.50 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $688.66 | ↓ -57% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $858.48 | ↓ -47% |
| Cigna | New Business ASO | $910.52 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $922.31 | ↓ -43% |
| Cigna | Commercial | $1,071.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,149.76 | ↓ -28% |
| Health Plan of Upper Ohio Valley | Commercial | $1,237.24 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,339.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $1,472.90 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $1,844.61 | ↑ +15% |
| Coventry/First Health | Commercial | $1,874.60 | ↑ +17% |
| InterGroup | PPO | $2,222.74 | ↑ +38% |
| Humana | Commercial | $2,276.30 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $2,276.30 | ↑ +42% |
| Private Health Care Systems | PPO | $2,276.30 | ↑ +42% |
Visitor-reported prices
Comments
Complx repair enel addl 5cm/< 13153 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,434.60 | $306.39 – $2,151.90 |
| UPMC Presbyterian | Pittsburgh | $2,219.40 | $142.16 – $3,144.15 |
| UPMC St. Margaret | Pittsburgh | $1,750.80 | $287.80 – $2,480.30 |
| UPMC Muncy | Muncy | $660.00 | $151.64 – $880.00 |
| UPMC Somerset | Somerset | $319.20 | $136.24 – $471.73 |
| UPMC Wellsboro | Wellsboro | $798.40 | $151.64 – $898.20 |