healthcosts.net
Fl exam g/colon tube w contrast at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$626.40
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.
$1,044.00
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.
$26.11 with UPMC Health Plan vs $1,761.91 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 | $26.11 | ↓ -96% |
| United Healthcare Community Plan for Families | Unison Kids | $27.30 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $35.21 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $37.06 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $40.46 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $214.16 | ↓ -66% |
| Health Plan of Upper Ohio Valley | Medicare | $230.45 | ↓ -63% |
| Health Plan of Upper Ohio Valley | Medicaid | $230.45 | ↓ -63% |
| United Healthcare | Unison Advantage Non Special Needs | $241.97 | ↓ -61% |
| Aetna of PA | Medicare | $241.97 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $248.86 | ↓ -60% |
| AmeriHealth Caritas | Medicare | $248.89 | ↓ -60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $248.89 | ↓ -60% |
| Aetna | Medicare | $253.50 | ↓ -60% |
| United Healthcare | Unison Advantage Special Needs | $253.50 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $255.42 | ↓ -59% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $295.44 | ↓ -53% |
| Private Health Care Systems | Workers' Comp | $297.00 | ↓ -53% |
| Cigna | New Business ASO | $354.96 | ↓ -43% |
| Cigna | Commercial | $417.60 | ↓ -33% |
| Health Plan of Upper Ohio Valley | Commercial | $482.33 | ↓ -23% |
| UPMC Health Plan | Commercial | $506.80 | ↓ -19% |
| Highmark BCBS of PA | Managed Care - Social Mission | $657.78 | ↑ +5% |
| Coventry/First Health | Commercial | $730.80 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $819.99 | ↑ +31% |
| InterGroup | PPO | $866.52 | ↑ +38% |
| Highmark BCBS of PA | Managed Care | $880.96 | ↑ +41% |
| Private Health Care Systems | PPO | $887.40 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $887.40 | ↑ +42% |
| Humana | Commercial | $887.40 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,098.21 | ↑ +75% |
| Highmark BCBS of PA | UPMC Emergent | $1,761.91 | ↑ +181% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Fl exam g/colon tube w contrast at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $780.60 | $26.11 – $1,170.90 |
| UPMC Presbyterian | Pittsburgh | $1,062.60 | $26.11 – $1,505.35 |
| UPMC St. Margaret | Pittsburgh | $1,487.40 | $26.11 – $2,107.15 |
| UPMC Northwest | Seneca | $602.40 | $26.11 – $853.40 |
| UPMC Somerset | Somerset | $1,728.00 | $26.11 – $2,160.00 |
| UPMC Wellsboro | Wellsboro | $2,151.20 | $26.11 – $2,420.10 |
| UPMC Williamsport | Williamsport | $1,778.40 | $26.11 – $2,371.20 |