healthcosts.net
Oth resp proc, group at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$72.00
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.
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What you pay up front if you don't use insurance.
$120.00
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.
$9.51 with Highmark BCBS of PA vs $102.00 with Private Health Care Systems — 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 BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $9.51 | ↓ -87% |
| Highmark BCBS of PA | Managed Care - Social Mission | $24.85 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $26.41 | ↓ -63% |
| Aetna | Medicare | $30.00 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $33.28 | ↓ -54% |
| UPMC Health Plan | Managed Medicare | $34.77 | ↓ -52% |
| Highmark BCBS of PA | Commercial - Indemnity | $35.37 | ↓ -51% |
| Health Plan of Upper Ohio Valley | Medicaid | $37.42 | ↓ -48% |
| Health Plan of Upper Ohio Valley | Medicare | $37.42 | ↓ -48% |
| Aetna of PA | Medicare | $39.29 | ↓ -45% |
| United Healthcare | Unison Advantage Non Special Needs | $39.29 | ↓ -45% |
| AmeriHealth Caritas | Medicare | $40.41 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicare | $40.41 | ↓ -44% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $40.41 | ↓ -44% |
| Cigna | New Business ASO | $40.80 | ↓ -43% |
| United Healthcare | Unison Advantage Special Needs | $41.16 | ↓ -43% |
| Cigna | Commercial | $48.00 | ↓ -33% |
| Health Plan of Upper Ohio Valley | Commercial | $55.44 | ↓ -23% |
| PA Health & Wellness | PA Medicaid HMO | $66.00 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $66.57 | ↓ -8% |
| Coventry/First Health | Commercial | $84.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $87.85 | ↑ +22% |
| InterGroup | PPO | $99.60 | ↑ +38% |
| Humana | Commercial | $102.00 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $102.00 | ↑ +42% |
| Private Health Care Systems | PPO | $102.00 | ↑ +42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| Private Health Care Systems | Workers' Comp | not published by hospital | — |
Visitor-reported prices
Comments
Oth resp proc, group at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $38.40 | $9.42 – $57.60 |
| UPMC Presbyterian | Pittsburgh | $70.20 | $9.51 – $99.45 |
| UPMC Somerset | Somerset | $304.80 | $9.33 – $381.00 |
| UPMC Wellsboro | Wellsboro | $473.60 | $26.52 – $532.80 |
| UPMC Williamsport | Williamsport | $391.80 | $26.52 – $587.70 |