healthcosts.net
Fna bx w/ct gdn ea addl at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$575.40
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.
?
What you pay up front if you don't use insurance.
$959.00
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.
$74.79 with UPMC Health Plan vs $1,005.85 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 | $74.79 | ↓ -87% |
| United Healthcare Community Plan for Families | Unison Kids | $78.19 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $100.83 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $106.14 | ↓ -82% |
| PA Health & Wellness | PA Medicaid HMO | $115.87 | ↓ -80% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $168.66 | ↓ -71% |
| Aetna | Medicare | $239.75 | ↓ -58% |
| Cigna | New Business ASO | $326.06 | ↓ -43% |
| UPMC Work Partners | Workers Comp | $331.38 | ↓ -42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $375.52 | ↓ -35% |
| Cigna | Commercial | $383.60 | ↓ -33% |
| Private Health Care Systems | Workers' Comp | $385.33 | ↓ -33% |
| Health Plan of Upper Ohio Valley | Commercial | $443.06 | ↓ -23% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $468.12 | ↓ -19% |
| Highmark Wholecare (prev Gateway) | Medicare | $479.50 | ↓ -17% |
| Highmark BCBS of PA | Managed Care | $502.92 | ↓ -13% |
| Highmark BCBS of PA | Commercial - Indemnity | $626.95 | ↑ +9% |
| UPMC Health Plan | Commercial | $651.26 | ↑ +13% |
| Coventry/First Health | Commercial | $671.30 | ↑ +17% |
| InterGroup | PPO | $795.97 | ↑ +38% |
| Humana | Commercial | $815.15 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $815.15 | ↑ +42% |
| Private Health Care Systems | PPO | $815.15 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $1,005.85 | ↑ +75% |
Visitor-reported prices
Comments
Fna bx w/ct gdn ea addl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $738.00 | $74.79 – $1,107.00 |
| UPMC Presbyterian | Pittsburgh | $1,085.40 | $74.79 – $1,537.65 |
| UPMC Muncy | Muncy | $726.00 | $74.79 – $968.00 |
| UPMC Somerset | Somerset | $314.40 | $74.79 – $393.00 |
| UPMC Wellsboro | Wellsboro | $877.60 | $74.79 – $987.30 |
| UPMC Williamsport | Williamsport | $726.00 | $74.79 – $968.00 |