healthcosts.net
Electron microscopy diagnostic at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$578.40
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.
$964.00
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.
$75.90 with UPMC Health Plan vs $856.70 with United Healthcare — 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 | $75.90 | ↓ -87% |
| United Healthcare Community Plan for Families | Unison Kids | $79.35 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $102.33 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $107.72 | ↓ -81% |
| PA Health & Wellness | PA Medicaid HMO | $117.59 | ↓ -80% |
| UPMC Health Plan | Commercial | $119.09 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $148.54 | ↓ -74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $257.96 | ↓ -55% |
| Cigna | New Business ASO | $291.04 | ↓ -50% |
| Cigna | Commercial | $342.40 | ↓ -41% |
| Highmark BCBS of PA | Managed Care | $345.48 | ↓ -40% |
| UPMC Work Partners | Workers Comp | $355.83 | ↓ -38% |
| Health Plan of Upper Ohio Valley | Commercial | $395.47 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $412.29 | ↓ -29% |
| Private Health Care Systems | Workers' Comp | $413.76 | ↓ -28% |
| Highmark BCBS of PA | Commercial - Indemnity | $552.17 | ↓ -5% |
| Coventry/First Health | Commercial | $599.20 | ↑ +4% |
| Highmark BCBS of PA | UPMC Emergent | $690.96 | ↑ +19% |
| InterGroup | PPO | $710.48 | ↑ +23% |
| UPMC Health Plan | Managed Medicare | $723.76 | ↑ +25% |
| Private Health Care Systems | PPO | $727.60 | ↑ +26% |
| Multiplan | PPO (Includes Workers' Comp) | $727.60 | ↑ +26% |
| Humana | Commercial | $727.60 | ↑ +26% |
| Health Plan of Upper Ohio Valley | Medicare | $778.82 | ↑ +35% |
| Health Plan of Upper Ohio Valley | Medicaid | $778.82 | ↑ +35% |
| United Healthcare | Unison Advantage Non Special Needs | $817.76 | ↑ +41% |
| Aetna of PA | Medicare | $817.76 | ↑ +41% |
| Highmark Wholecare (prev Gateway) | Medicare | $841.05 | ↑ +45% |
| AmeriHealth Caritas | Medicare | $841.13 | ↑ +45% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $841.13 | ↑ +45% |
| Aetna | Medicare | $856.70 | ↑ +48% |
| United Healthcare | Unison Advantage Special Needs | $856.70 | ↑ +48% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Electron microscopy diagnostic at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $554.40 | $75.90 – $831.60 |
| UPMC Presbyterian | Pittsburgh | $6,864.00 | $21.00 – $856.70 |
| UPMC St. Margaret | Pittsburgh | $2,203.80 | $75.90 – $817.76 |
| UPMC Northwest | Seneca | $1,386.00 | $75.90 – $1,963.50 |
| UPMC Somerset | Somerset | $1,472.40 | $20.12 – $1,323.75 |
| UPMC Williamsport | Williamsport | $1,084.80 | $22.40 – $1,446.40 |