healthcosts.net
Cyclophosphamide 25 mg capsule at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$67.20
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.
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What you pay up front if you don't use insurance.
$112.00
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.
$0.69 with UPMC Health Plan vs $17.39 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 Medicaid | $0.69 | ↓ -99% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $1.04 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $1.10 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1.10 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $1.10 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison Kids | $1.14 | ↓ -98% |
| UPMC Health Plan | Commercial | $1.35 | ↓ -98% |
| Aetna | Medicare | $3.50 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $3.79 | ↓ -94% |
| Cigna | New Business ASO | $4.76 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $5.04 | ↓ -93% |
| Cigna | Commercial | $5.60 | ↓ -92% |
| Private Health Care Systems | Workers' Comp | $5.86 | ↓ -91% |
| Health Plan of Upper Ohio Valley | Commercial | $6.47 | ↓ -90% |
| Highmark BCBS of PA | Managed Care - Social Mission | $6.49 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $6.56 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $7.00 | ↓ -90% |
| Highmark BCBS of PA | Managed Care | $8.70 | ↓ -87% |
| Highmark BCBS of PA | Commercial - Indemnity | $8.79 | ↓ -87% |
| Coventry/First Health | Commercial | $9.80 | ↓ -85% |
| InterGroup | PPO | $11.62 | ↓ -83% |
| Humana | Commercial | $11.90 | ↓ -82% |
| Multiplan | PPO (Includes Workers' Comp) | $11.90 | ↓ -82% |
| Private Health Care Systems | PPO | $11.90 | ↓ -82% |
| Highmark BCBS of PA | UPMC Emergent | $17.39 | ↓ -74% |
Visitor-reported prices
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Cyclophosphamide 25 mg capsule at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $28.20 | $0.69 – $18.90 |
| UPMC Presbyterian | Pittsburgh | $133.20 | $0.69 – $93.50 |
| UPMC St. Margaret | Pittsburgh | $30.60 | $0.69 – $10.20 |
| UPMC Western Psychiatric | Pittsburgh | $67.20 | $1.10 – $95.20 |
| UPMC Muncy | Muncy | $43.20 | $1.10 – $64.80 |
| UPMC Somerset | Somerset | $7.80 | $0.72 – $3.72 |
| UPMC Wellsboro | Wellsboro | $43.20 | $1.10 – $64.80 |