Rpm tx mgmt 1st 20 min at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$209.40
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.
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What you pay up front if you don't use insurance.
$349.00
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.
$30.70 with Highmark BCBS of PA vs $296.65 with Humana — 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 | $30.70 | ↓ -85% |
| Aetna of PA | Medicare | $36.08 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $60.30 | ↓ -71% |
| Private Health Care Systems | Workers' Comp | $70.12 | ↓ -67% |
| Highmark BCBS of PA | Managed Care - Social Mission | $84.30 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $85.21 | ↓ -59% |
| Aetna | Medicare | $87.25 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $112.90 | ↓ -46% |
| Highmark BCBS of PA | Commercial - Indemnity | $114.12 | ↓ -46% |
| Cigna | New Business ASO | $118.66 | ↓ -43% |
| Cigna | Commercial | $139.60 | ↓ -33% |
| UPMC Health Plan | Commercial | $147.42 | ↓ -30% |
| Health Plan of Upper Ohio Valley | Commercial | $161.24 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $174.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $191.95 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $225.80 | ↑ +8% |
| Coventry/First Health | Commercial | $244.30 | ↑ +17% |
| InterGroup | PPO | $289.67 | ↑ +38% |
| Multiplan | PPO (Includes Workers' Comp) | $296.65 | ↑ +42% |
| Private Health Care Systems | PPO | $296.65 | ↑ +42% |
| Humana | Commercial | $296.65 | ↑ +42% |
Visitor-reported prices
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Rpm tx mgmt 1st 20 min at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $211.20 | $30.41 – $66.19 |
| UPMC Presbyterian | Pittsburgh | $317.40 | $22.08 – $76.97 |
| UPMC St. Margaret | Pittsburgh | $219.60 | $30.70 – $60.30 |
| UPMC Horizon-Greenville | Greenville | $223.80 | $60.30 – $94.58 |
| UPMC Williamsport | Williamsport | $234.00 | $23.55 – $66.61 |