healthcosts.net
Lower Back (Lumbar Spine) MRI (with and without contrast) at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$5,999.40
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.
?
What you pay up front if you don't use insurance.
$9,999.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$316.41 with UPMC Health Plan vs $8,499.15 with Humana — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $316.41 | ↓ -95% |
| Health Plan of Upper Ohio Valley | Medicare | $340.48 | ↓ -94% |
| Health Plan of Upper Ohio Valley | Medicaid | $340.48 | ↓ -94% |
| United Healthcare | Unison Advantage Non Special Needs | $357.50 | ↓ -94% |
| Aetna of PA | Medicare | $357.50 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $367.68 | ↓ -94% |
| AmeriHealth Caritas | Medicare | $367.72 | ↓ -94% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $367.72 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $372.90 | ↓ -94% |
| Aetna | Medicare | $374.53 | ↓ -94% |
| United Healthcare | Unison Advantage Special Needs | $374.53 | ↓ -94% |
| United Healthcare Community Plan for Families | Unison Kids | $389.85 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $502.74 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $529.21 | ↓ -91% |
| PA Health & Wellness | PA Medicaid HMO | $577.72 | ↓ -90% |
| UPMC Health Plan | Commercial | $1,053.12 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,214.10 | ↓ -80% |
| Premier Comp Solutions | Worker's Comp | $2,428.73 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $2,610.88 | ↓ -56% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,703.17 | ↓ -55% |
| Private Health Care Systems | Workers' Comp | $3,035.91 | ↓ -49% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,369.77 | ↓ -44% |
| Cigna | New Business ASO | $3,399.66 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $3,620.29 | ↓ -40% |
| Cigna | Commercial | $3,999.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,513.08 | ↓ -25% |
| Health Plan of Upper Ohio Valley | Commercial | $4,619.54 | ↓ -23% |
| Coventry/First Health | Commercial | $6,999.30 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $7,240.58 | ↑ +21% |
| InterGroup | PPO | $8,299.17 | ↑ +38% |
| Private Health Care Systems | PPO | $8,499.15 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $8,499.15 | ↑ +42% |
| Humana | Commercial | $8,499.15 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) MRI (with and without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $6,741.00 | $318.66 – $10,336.20 |
| UPMC Mercy | Pittsburgh | $6,512.40 | $283.82 – $9,768.60 |
| UPMC Presbyterian | Pittsburgh | $9,808.20 | $322.80 – $13,894.95 |
| UPMC St. Margaret | Pittsburgh | $5,810.40 | $293.97 – $8,231.40 |
| UPMC East | Monroeville | $6,218.40 | $341.40 – $8,291.20 |
| UPMC Hamot | Erie | $2,536.20 | $281.64 – $2,958.90 |
| UPMC Carlisle | Carlisle | $2,713.80 | $338.22 – $3,844.55 |
| UPMC Bedford | Everett | $2,884.20 | $122.85 – $4,326.30 |