Inj, adalimumab, 1 mg at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$220.20
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.
$367.00
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.
$55.08 with Cigna vs $3,869.74 with United Healthcare Community Plan for Families — 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 |
|---|---|---|---|
| Cigna | New Business ASO | $55.08 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $58.30 | ↓ -74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $63.18 | ↓ -71% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $63.18 | ↓ -71% |
| Highmark BCBS of PA | Managed Care | $63.18 | ↓ -71% |
| Highmark BCBS of PA | Commercial - Indemnity | $63.18 | ↓ -71% |
| Cigna | Commercial | $64.80 | ↓ -71% |
| Private Health Care Systems | Workers' Comp | $67.80 | ↓ -69% |
| UPMC Health Plan | Commercial | $68.43 | ↓ -69% |
| Health Plan of Upper Ohio Valley | Commercial | $74.84 | ↓ -66% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $81.00 | ↓ -63% |
| UPMC Health Plan | Managed Medicare | $85.24 | ↓ -61% |
| PA Health & Wellness | PA Medicaid HMO | $89.10 | ↓ -60% |
| Health Plan of Upper Ohio Valley | Medicare | $91.73 | ↓ -58% |
| Health Plan of Upper Ohio Valley | Medicaid | $91.73 | ↓ -58% |
| United Healthcare | Unison Advantage Non Special Needs | $96.32 | ↓ -56% |
| Aetna of PA | Medicare | $96.32 | ↓ -56% |
| Highmark Wholecare (prev Gateway) | Medicare | $99.06 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $99.07 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $99.07 | ↓ -55% |
| United Healthcare | Unison Advantage Special Needs | $100.90 | ↓ -54% |
| Aetna | Medicare | $100.90 | ↓ -54% |
| Coventry/First Health | Commercial | $113.40 | ↓ -49% |
| Highmark BCBS of PA | UPMC Emergent | $126.36 | ↓ -43% |
| InterGroup | PPO | $134.46 | ↓ -39% |
| Humana | Commercial | $137.70 | ↓ -37% |
| Multiplan | PPO (Includes Workers' Comp) | $137.70 | ↓ -37% |
| Private Health Care Systems | PPO | $137.70 | ↓ -37% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $3,533.24 | ↑ +1505% |
| United Healthcare Community Plan for Families | Unison Kids | $3,869.74 | ↑ +1657% |
Visitor-reported prices
Comments
Inj, adalimumab, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| AHN WEXFORD HOSPITAL | WEXFORD | not published | $59.26 – $192.62 |
| GROVE CITY HOSPITAL | GROVE CITY | not published | $73.55 – $192.62 |