healthcosts.net
Established Patient Office Visit (level 1) at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$108.60
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.
?
What you pay up front if you don't use insurance.
$181.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$22.00 with UPMC Health Plan vs $162.31 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $22.00 | ↓ -80% |
| United Healthcare Community Plan for Families | Unison Kids | $23.00 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.66 | ↓ -73% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.22 | ↓ -71% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $34.04 | ↓ -69% |
| PA Health & Wellness | PA Medicaid HMO | $34.08 | ↓ -69% |
| Aetna of PA | Medicare | $36.08 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $41.25 | ↓ -62% |
| Aetna | Medicare | $45.25 | ↓ -58% |
| Private Health Care Systems | Workers' Comp | $47.96 | ↓ -56% |
| Highmark BCBS of PA | Managed Care - Social Mission | $60.60 | ↓ -44% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $61.25 | ↓ -44% |
| Cigna | Commercial | $63.91 | ↓ -41% |
| Cigna | New Business ASO | $63.91 | ↓ -41% |
| Highmark BCBS of PA | Managed Care | $81.16 | ↓ -25% |
| Highmark BCBS of PA | Commercial - Indemnity | $82.03 | ↓ -24% |
| Health Plan of Upper Ohio Valley | Commercial | $83.62 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $90.50 | ↓ -17% |
| Coventry/First Health | Commercial | $126.70 | ↑ +17% |
| InterGroup | PPO | $150.23 | ↑ +38% |
| Humana | Commercial | $153.85 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $153.85 | ↑ +42% |
| Private Health Care Systems | PPO | $153.85 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $162.31 | ↑ +49% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $118.20 | $19.03 – $171.12 |
| UPMC Mercy | Pittsburgh | $100.20 | $22.00 – $150.30 |
| UPMC Presbyterian | Pittsburgh | $96.60 | $22.00 – $136.85 |
| UPMC St. Margaret | Pittsburgh | $122.40 | $22.00 – $173.40 |
| UPMC Western Psychiatric | Pittsburgh | $186.60 | $33.36 – $118.15 |
| UPMC Altoona | Altoona | $174.60 | $6.00 – $232.80 |
| UPMC Bedford | Everett | $83.40 | $21.00 – $125.10 |
| UPMC Cole | Coudersport | $84.00 | $19.64 – $70.40 |