healthcosts.net
Coombs direct at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$67.80
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.
$113.00
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.
$5.01 with UPMC Health Plan vs $96.05 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 Medicare | $5.01 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $5.32 | ↓ -92% |
| Health Plan of Upper Ohio Valley | Medicare | $5.39 | ↓ -92% |
| Health Plan of Upper Ohio Valley | Medicaid | $5.39 | ↓ -92% |
| UPMC Health Plan | Commercial | $5.58 | ↓ -92% |
| United Healthcare | Unison Advantage Non Special Needs | $5.66 | ↓ -92% |
| Aetna of PA | Medicare | $5.66 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $5.82 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $5.82 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5.82 | ↓ -91% |
| Aetna | Medicare | $5.93 | ↓ -91% |
| United Healthcare | Unison Advantage Special Needs | $5.93 | ↓ -91% |
| Private Health Care Systems | Workers' Comp | $6.19 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $8.17 | ↓ -88% |
| United Healthcare Community Plan for Families | Unison Kids | $8.54 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $10.47 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $11.02 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $11.60 | ↓ -83% |
| PA Health & Wellness | PA Medicaid HMO | $12.66 | ↓ -81% |
| Highmark BCBS of PA | Managed Care - Social Mission | $18.18 | ↓ -73% |
| Highmark BCBS of PA | Managed Care | $24.35 | ↓ -64% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $29.06 | ↓ -57% |
| Cigna | New Business ASO | $38.42 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Indemnity | $38.92 | ↓ -43% |
| Cigna | Commercial | $45.20 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $48.71 | ↓ -28% |
| Health Plan of Upper Ohio Valley | Commercial | $52.21 | ↓ -23% |
| Coventry/First Health | Commercial | $79.10 | ↑ +17% |
| InterGroup | PPO | $93.79 | ↑ +38% |
| Private Health Care Systems | PPO | $96.05 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $96.05 | ↑ +42% |
| Humana | Commercial | $96.05 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Coombs direct at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $98.40 | $4.49 – $147.60 |
| UPMC Presbyterian | Pittsburgh | $153.00 | $5.32 – $216.75 |
| UPMC St. Margaret | Pittsburgh | $80.40 | $4.65 – $113.90 |
| UPMC Muncy | Muncy | $70.20 | $5.32 – $93.60 |
| UPMC Northwest | Seneca | $37.20 | $4.89 – $52.70 |
| UPMC Somerset | Somerset | $75.00 | $5.32 – $60.00 |
| UPMC Wellsboro | Wellsboro | $84.80 | $5.32 – $95.40 |
| UPMC Williamsport | Williamsport | $70.20 | $5.32 – $93.60 |