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Icd crtd cobalt hf MRI is1 df1 at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$54,276.00
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.
$90,460.00
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.
$0.22 with Highmark Wholecare (prev Gateway) vs $130,021.45 with UPMC Health Plan — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $0.22 | ↓ -100% |
| Aetna | Medicare | $0.25 | ↓ -100% |
| PA Health & Wellness | PA Medicaid HMO | $0.33 | ↓ -100% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.34 | ↓ -100% |
| Cigna | New Business ASO | $0.34 | ↓ -100% |
| Cigna | Commercial | $0.40 | ↓ -100% |
| Health Plan of Upper Ohio Valley | Commercial | $0.46 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicare | $0.50 | ↓ -100% |
| Coventry/First Health | Commercial | $0.70 | ↓ -100% |
| InterGroup | PPO | $0.83 | ↓ -100% |
| Humana | Commercial | $0.85 | ↓ -100% |
| Multiplan | PPO (Includes Workers' Comp) | $0.85 | ↓ -100% |
| Private Health Care Systems | PPO | $0.85 | ↓ -100% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $16,375.39 | ↓ -70% |
| Highmark BCBS of PA | Managed Care - Social Mission | $44,965.35 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $45,450.54 | ↓ -16% |
| Highmark BCBS of PA | Managed Care | $60,222.86 | ↑ +11% |
| Highmark BCBS of PA | Commercial - Indemnity | $60,871.25 | ↑ +12% |
| Highmark BCBS of PA | UPMC Emergent | $120,445.73 | ↑ +122% |
| UPMC Health Plan | Commercial | $130,021.45 | ↑ +140% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Private Health Care Systems | Workers' Comp | not published by hospital | — |
Visitor-reported prices
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Icd crtd cobalt hf MRI is1 df1 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $60,282.00 | $10,351.20 – $70,752.35 |
| UPMC Presbyterian | Pittsburgh | $146,978.40 | $0.12 – $144,867.92 |
| UPMC Northwest | Seneca | $40,346.40 | $16,811.00 – $108,424.54 |
| UPMC Somerset | Somerset | $45,067.20 | $15,022.40 – $56,334.00 |
| UPMC Williamsport | Williamsport | $64,147.20 | $9,211.20 – $41,450.40 |