healthcosts.net
Hcg qualitative at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$42.00
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.
$70.00
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.
$6.99 with UPMC Health Plan vs $68.17 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 Medicare | $6.99 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $7.43 | ↓ -82% |
| Health Plan of Upper Ohio Valley | Medicaid | $7.52 | ↓ -82% |
| Health Plan of Upper Ohio Valley | Medicare | $7.52 | ↓ -82% |
| Aetna of PA | Medicare | $7.90 | ↓ -81% |
| United Healthcare | Unison Advantage Non Special Needs | $7.90 | ↓ -81% |
| AmeriHealth Caritas | Medicare | $8.12 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicare | $8.12 | ↓ -81% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $8.12 | ↓ -81% |
| Aetna | Medicare | $8.27 | ↓ -80% |
| United Healthcare | Unison Advantage Special Needs | $8.27 | ↓ -80% |
| Private Health Care Systems | Workers' Comp | $8.64 | ↓ -79% |
| UPMC Health Plan | Commercial | $8.98 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $11.29 | ↓ -73% |
| United Healthcare Community Plan for Families | Unison Kids | $11.80 | ↓ -72% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $14.66 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicaid | $15.22 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $16.02 | ↓ -62% |
| PA Health & Wellness | PA Medicaid HMO | $17.49 | ↓ -58% |
| Cigna | New Business ASO | $22.44 | ↓ -47% |
| Highmark BCBS of PA | Managed Care - Social Mission | $25.45 | ↓ -39% |
| Cigna | Commercial | $26.40 | ↓ -37% |
| Health Plan of Upper Ohio Valley | Commercial | $30.49 | ↓ -27% |
| Highmark BCBS of PA | Managed Care | $34.09 | ↓ -19% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $40.68 | ↓ -3% |
| Coventry/First Health | Commercial | $46.20 | ↑ +10% |
| Highmark BCBS of PA | Commercial - Indemnity | $54.48 | ↑ +30% |
| InterGroup | PPO | $54.78 | ↑ +30% |
| Humana | Commercial | $56.10 | ↑ +34% |
| Multiplan | PPO (Includes Workers' Comp) | $56.10 | ↑ +34% |
| Private Health Care Systems | PPO | $56.10 | ↑ +34% |
| Highmark BCBS of PA | UPMC Emergent | $68.17 | ↑ +62% |
Visitor-reported prices
Comments
Hcg qualitative at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $90.60 | $6.27 – $135.90 |
| UPMC Presbyterian | Pittsburgh | $645.60 | $7.43 – $96.05 |
| UPMC St. Margaret | Pittsburgh | $85.20 | $6.49 – $120.70 |
| UPMC Muncy | Muncy | $102.60 | $7.43 – $136.80 |
| UPMC Northwest | Seneca | $74.40 | $6.82 – $105.40 |
| UPMC Somerset | Somerset | $39.00 | $7.43 – $48.75 |
| UPMC Wellsboro | Wellsboro | $124.00 | $7.43 – $139.50 |
| UPMC Williamsport | Williamsport | $102.60 | $7.43 – $136.80 |