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Endo abl/incom vein/ext/rad fre/#1 36475 at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$18,056.40
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.
$30,094.00
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.
$2,788.61 with UPMC Health Plan vs $25,579.90 with Private Health Care Systems — 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 | $2,788.61 | ↓ -85% |
| Health Plan of Upper Ohio Valley | Medicaid | $3,000.76 | ↓ -83% |
| Health Plan of Upper Ohio Valley | Medicare | $3,000.76 | ↓ -83% |
| Aetna of PA | Medicare | $3,150.80 | ↓ -83% |
| United Healthcare | Unison Advantage Non Special Needs | $3,150.80 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,240.52 | ↓ -82% |
| AmeriHealth Caritas | Medicare | $3,240.82 | ↓ -82% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,240.82 | ↓ -82% |
| Aetna | Medicare | $3,300.84 | ↓ -82% |
| United Healthcare | Unison Advantage Special Needs | $3,300.84 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $3,749.62 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $3,846.69 | ↓ -79% |
| Private Health Care Systems | Workers' Comp | $4,360.02 | ↓ -76% |
| UPMC Health Plan | Commercial | $4,586.18 | ↓ -75% |
| Highmark BCBS of PA | Managed Care - Social Mission | $8,564.61 | ↓ -53% |
| Cigna | New Business ASO | $10,231.96 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $10,676.65 | ↓ -41% |
| Highmark BCBS of PA | Managed Care | $11,470.38 | ↓ -36% |
| Cigna | Commercial | $12,037.60 | ↓ -33% |
| Health Plan of Upper Ohio Valley | Commercial | $13,903.43 | ↓ -23% |
| Highmark BCBS of PA | Commercial - Indemnity | $14,299.08 | ↓ -21% |
| PA Health & Wellness | PA Medicaid HMO | $16,551.70 | ↓ -8% |
| Coventry/First Health | Commercial | $21,065.80 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $22,940.77 | ↑ +27% |
| InterGroup | PPO | $24,978.02 | ↑ +38% |
| Humana | Commercial | $25,579.90 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $25,579.90 | ↑ +42% |
| Private Health Care Systems | PPO | $25,579.90 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Endo abl/incom vein/ext/rad fre/#1 36475 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $15,871.80 | $2,274.00 – $23,807.70 |
| UPMC Presbyterian | Pittsburgh | $20,209.20 | $931.20 – $28,629.70 |
| UPMC St. Margaret | Pittsburgh | $17,545.20 | $2,590.86 – $24,855.70 |
| UPMC Williamsport | Williamsport | $3,715.20 | $993.28 – $4,953.60 |
| UPMC Northwest | Seneca | not published | $2,721.39 – $3,749.62 |