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Dornhoffer fixed part w/window at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$29,415.60
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.
$49,026.00
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.
$10,785.72 with Highmark Wholecare (prev Gateway) vs $161,394.92 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $10,785.72 | ↓ -63% |
| Aetna | Medicare | $12,256.50 | ↓ -58% |
| Cigna | New Business ASO | $16,668.84 | ↓ -43% |
| Cigna | Commercial | $19,610.40 | ↓ -33% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $21,942.70 | ↓ -25% |
| Health Plan of Upper Ohio Valley | Commercial | $22,650.01 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $24,513.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $26,964.30 | ↓ -8% |
| Coventry/First Health | Commercial | $34,318.20 | ↑ +17% |
| InterGroup | PPO | $40,691.58 | ↑ +38% |
| Humana | Commercial | $41,672.10 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $41,672.10 | ↑ +42% |
| Private Health Care Systems | PPO | $41,672.10 | ↑ +42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $60,252.69 | ↑ +105% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $60,902.84 | ↑ +107% |
| Highmark BCBS of PA | Managed Care | $80,697.46 | ↑ +174% |
| Highmark BCBS of PA | Commercial - Indemnity | $81,566.28 | ↑ +177% |
| UPMC Health Plan | Commercial | $99,248.70 | ↑ +237% |
| Highmark BCBS of PA | UPMC Emergent | $161,394.92 | ↑ +449% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Private Health Care Systems | Workers' Comp | not published by hospital | — |
Visitor-reported prices
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Dornhoffer fixed part w/window at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $53,356.20 | $403.44 – $54,007.08 |
| UPMC Presbyterian | Pittsburgh | $54,599.40 | $0.96 – $110,581.39 |
| UPMC Muncy | Muncy | $36,517.20 | $9,129.30 – $54,775.80 |
| UPMC Wellsboro | Wellsboro | $44,163.20 | $9,936.72 – $49,683.60 |