healthcosts.net
Immune complex assay at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$192.60
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.
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What you pay up front if you don't use insurance.
$321.00
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.
$22.65 with UPMC Health Plan vs $272.85 with Private Health Care Systems — 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 | $22.65 | ↓ -88% |
| UPMC Work Partners | Workers Comp | $24.09 | ↓ -87% |
| Health Plan of Upper Ohio Valley | Medicaid | $24.37 | ↓ -87% |
| Health Plan of Upper Ohio Valley | Medicare | $24.37 | ↓ -87% |
| Aetna of PA | Medicare | $25.59 | ↓ -87% |
| United Healthcare | Unison Advantage Non Special Needs | $25.59 | ↓ -87% |
| AmeriHealth Caritas | Medicare | $26.32 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicare | $26.32 | ↓ -86% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $26.32 | ↓ -86% |
| Aetna | Medicare | $26.81 | ↓ -86% |
| United Healthcare | Unison Advantage Special Needs | $26.81 | ↓ -86% |
| Private Health Care Systems | Workers' Comp | $28.01 | ↓ -85% |
| UPMC Health Plan | Managed Medicaid | $33.00 | ↓ -83% |
| United Healthcare Community Plan for Families | Unison Kids | $34.50 | ↓ -82% |
| UPMC Health Plan | Commercial | $35.46 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $44.49 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $46.83 | ↓ -76% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $47.55 | ↓ -75% |
| PA Health & Wellness | PA Medicaid HMO | $51.13 | ↓ -73% |
| Highmark BCBS of PA | Managed Care - Social Mission | $82.58 | ↓ -57% |
| Cigna | New Business ASO | $109.14 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $110.59 | ↓ -43% |
| Cigna | Commercial | $128.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $131.98 | ↓ -31% |
| Health Plan of Upper Ohio Valley | Commercial | $148.30 | ↓ -23% |
| Highmark BCBS of PA | Commercial - Indemnity | $176.76 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $221.18 | ↑ +15% |
| Coventry/First Health | Commercial | $224.70 | ↑ +17% |
| InterGroup | PPO | $266.43 | ↑ +38% |
| Humana | Commercial | $272.85 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $272.85 | ↑ +42% |
| Private Health Care Systems | PPO | $272.85 | ↑ +42% |
Visitor-reported prices
Comments
Immune complex assay at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $186.00 | $20.31 – $279.00 |
| UPMC Presbyterian | Pittsburgh | $421.80 | $24.09 – $597.55 |
| UPMC St. Margaret | Pittsburgh | $412.20 | $21.04 – $583.95 |
| UPMC Northwest | Seneca | $289.20 | $22.10 – $409.70 |
| UPMC Somerset | Somerset | $88.80 | $24.09 – $111.00 |
| UPMC Williamsport | Williamsport | $168.00 | $24.09 – $224.00 |