healthcosts.net
Shoe post-op mens m at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$561.00
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.
$935.00
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.
$62.82 with UPMC Health Plan vs $3,174.51 with Highmark BCBS of PA — 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 | Commercial | $62.82 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $183.26 | ↓ -67% |
| Aetna | Medicare | $208.25 | ↓ -63% |
| Cigna | New Business ASO | $283.22 | ↓ -50% |
| Cigna | Commercial | $333.20 | ↓ -41% |
| Health Plan of Upper Ohio Valley | Commercial | $384.85 | ↓ -31% |
| Highmark Wholecare (prev Gateway) | Medicare | $416.50 | ↓ -26% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $431.60 | ↓ -23% |
| PA Health & Wellness | PA Medicaid HMO | $458.15 | ↓ -18% |
| Coventry/First Health | Commercial | $583.10 | ↑ +4% |
| InterGroup | PPO | $691.39 | ↑ +23% |
| Humana | Commercial | $708.05 | ↑ +26% |
| Multiplan | PPO (Includes Workers' Comp) | $708.05 | ↑ +26% |
| Private Health Care Systems | PPO | $708.05 | ↑ +26% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,185.12 | ↑ +111% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,197.91 | ↑ +114% |
| Highmark BCBS of PA | Managed Care | $1,587.25 | ↑ +183% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,604.34 | ↑ +186% |
| Highmark BCBS of PA | UPMC Emergent | $3,174.51 | ↑ +466% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Private Health Care Systems | Workers' Comp | not published by hospital | — |
Visitor-reported prices
Comments
Shoe post-op mens m at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $315.60 | $3.96 – $431.60 |
| UPMC Wellsboro | Wellsboro | $75.60 | $17.01 – $85.05 |