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Inj proc myelogram lumbar at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$1,000.80
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.
$1,668.00
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.
$87.49 with UPMC Health Plan vs $2,014.38 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 Medicaid | $87.49 | ↓ -91% |
| United Healthcare Community Plan for Families | Unison Kids | $91.47 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $117.96 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $124.17 | ↓ -88% |
| PA Health & Wellness | PA Medicaid HMO | $135.55 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $337.77 | ↓ -66% |
| Aetna | Medicare | $417.00 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $448.22 | ↓ -55% |
| Private Health Care Systems | Workers' Comp | $521.19 | ↓ -48% |
| Cigna | New Business ASO | $567.12 | ↓ -43% |
| UPMC Health Plan | Commercial | $593.49 | ↓ -41% |
| Cigna | Commercial | $667.20 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $752.04 | ↓ -25% |
| Health Plan of Upper Ohio Valley | Commercial | $770.62 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $834.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $937.49 | ↓ -6% |
| Highmark BCBS of PA | Managed Care | $1,007.19 | ↑ +1% |
| Coventry/First Health | Commercial | $1,167.60 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,255.57 | ↑ +25% |
| InterGroup | PPO | $1,384.44 | ↑ +38% |
| Humana | Commercial | $1,417.80 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $1,417.80 | ↑ +42% |
| Private Health Care Systems | PPO | $1,417.80 | ↑ +42% |
| Highmark BCBS of PA | UPMC Emergent | $2,014.38 | ↑ +101% |
Visitor-reported prices
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Inj proc myelogram lumbar at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $2,250.60 | $87.49 – $3,375.90 |
| UPMC Presbyterian | Pittsburgh | $2,289.60 | $87.49 – $3,243.60 |
| UPMC Muncy | Muncy | $1,094.40 | $87.49 – $1,459.20 |
| UPMC Somerset | Somerset | $518.40 | $87.49 – $685.40 |
| UPMC Wellsboro | Wellsboro | $1,323.20 | $87.49 – $1,488.60 |
| UPMC Northwest | Seneca | not published | $87.49 – $868.37 |