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Membrane collgn porcine maci w/autologous cult chondrocytes at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$50,047.20
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.
$83,412.00
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.
$12,692.02 with Highmark Wholecare (prev Gateway) vs $224,767.45 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $12,692.02 | ↓ -75% |
| Aetna | Medicare | $14,422.75 | ↓ -71% |
| PA Health & Wellness | PA Medicaid HMO | $19,038.03 | ↓ -62% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $19,516.87 | ↓ -61% |
| Cigna | New Business ASO | $19,614.94 | ↓ -61% |
| Cigna | Commercial | $23,076.40 | ↓ -54% |
| Health Plan of Upper Ohio Valley | Commercial | $24,114.84 | ↓ -52% |
| UPMC Health Plan | Commercial | $24,368.68 | ↓ -51% |
| Highmark Wholecare (prev Gateway) | Medicare | $28,845.50 | ↓ -42% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $30,558.61 | ↓ -39% |
| Coventry/First Health | Commercial | $40,383.70 | ↓ -19% |
| InterGroup | PPO | $47,883.53 | ↓ -4% |
| Humana | Commercial | $49,037.35 | ↓ -2% |
| Multiplan | PPO (Includes Workers' Comp) | $49,037.35 | ↓ -2% |
| Private Health Care Systems | PPO | $49,037.35 | ↓ -2% |
| Highmark BCBS of PA | Managed Care - Social Mission | $83,911.20 | ↑ +68% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $84,816.64 | ↑ +69% |
| Highmark BCBS of PA | Managed Care | $112,383.72 | ↑ +125% |
| Highmark BCBS of PA | Commercial - Indemnity | $113,593.69 | ↑ +127% |
| Highmark BCBS of PA | UPMC Emergent | $224,767.45 | ↑ +349% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Private Health Care Systems | Workers' Comp | not published by hospital | — |
Visitor-reported prices
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Membrane collgn porcine maci w/autologous cult chondrocytes at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $308,663.40 | $11,574.90 – $54,659.25 |
| UPMC St. Margaret | Pittsburgh | $77,166.00 | $16,076.25 – $54,659.25 |
| UPMC Williamsport | Williamsport | $114,657.00 | $17,198.46 – $57,328.20 |