healthcosts.net
Mayo factor xi at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$201.00
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.
?
What you pay up front if you don't use insurance.
$335.00
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.
$13.20 with UPMC Health Plan vs $284.75 with Private Health Care Systems — 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 Medicaid | $13.20 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison Kids | $13.80 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $16.63 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $17.69 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $17.80 | ↓ -91% |
| Health Plan of Upper Ohio Valley | Medicaid | $17.90 | ↓ -91% |
| Health Plan of Upper Ohio Valley | Medicare | $17.90 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $18.73 | ↓ -91% |
| Aetna of PA | Medicare | $18.80 | ↓ -91% |
| United Healthcare | Unison Advantage Non Special Needs | $18.80 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $19.33 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $19.33 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $19.33 | ↓ -90% |
| Aetna | Medicare | $19.69 | ↓ -90% |
| United Healthcare | Unison Advantage Special Needs | $19.69 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $20.45 | ↓ -90% |
| Private Health Care Systems | Workers' Comp | $20.57 | ↓ -90% |
| UPMC Health Plan | Commercial | $28.53 | ↓ -86% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $39.03 | ↓ -81% |
| Highmark BCBS of PA | Managed Care - Social Mission | $67.78 | ↓ -66% |
| Highmark BCBS of PA | Managed Care | $90.78 | ↓ -55% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $108.33 | ↓ -46% |
| Cigna | New Business ASO | $113.90 | ↓ -43% |
| Cigna | Commercial | $134.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $145.09 | ↓ -28% |
| Health Plan of Upper Ohio Valley | Commercial | $154.77 | ↓ -23% |
| Highmark BCBS of PA | UPMC Emergent | $181.55 | ↓ -10% |
| Coventry/First Health | Commercial | $234.50 | ↑ +17% |
| InterGroup | PPO | $278.05 | ↑ +38% |
| Humana | Commercial | $284.75 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $284.75 | ↑ +42% |
| Private Health Care Systems | PPO | $284.75 | ↑ +42% |
Visitor-reported prices
Comments
Mayo factor xi at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $150.60 | $13.20 – $225.90 |
| UPMC Presbyterian | Pittsburgh | $1,503.00 | $12.00 – $2,129.25 |
| UPMC St. Margaret | Pittsburgh | $303.00 | $13.20 – $429.25 |
| UPMC Muncy | Muncy | $162.60 | $13.20 – $216.80 |
| UPMC Northwest | Seneca | $131.40 | $13.20 – $186.15 |
| UPMC Somerset | Somerset | $91.20 | $13.20 – $61.50 |
| UPMC Wellsboro | Wellsboro | $196.80 | $12.00 – $221.40 |
| UPMC Williamsport | Williamsport | $162.60 | $13.20 – $216.80 |