healthcosts.net
Sig w/tndsc balloon dilation at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$3,763.20
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.
$6,272.00
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.
$109.36 with UPMC Health Plan vs $5,331.20 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $109.36 | ↓ -97% |
| United Healthcare Community Plan for Families | Unison Kids | $114.33 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $147.44 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $155.20 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $169.43 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $589.95 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $597.85 | ↓ -84% |
| UPMC Health Plan | Commercial | $608.50 | ↓ -84% |
| Private Health Care Systems | Workers' Comp | $695.17 | ↓ -82% |
| UPMC Health Plan | Managed Medicare | $1,044.64 | ↓ -72% |
| Health Plan of Upper Ohio Valley | Medicare | $1,124.11 | ↓ -70% |
| Health Plan of Upper Ohio Valley | Medicaid | $1,124.11 | ↓ -70% |
| United Healthcare | Unison Advantage Non Special Needs | $1,180.32 | ↓ -69% |
| Aetna of PA | Medicare | $1,180.32 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,213.93 | ↓ -68% |
| AmeriHealth Caritas | Medicare | $1,214.04 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,214.04 | ↓ -68% |
| Aetna | Medicare | $1,236.52 | ↓ -67% |
| United Healthcare | Unison Advantage Special Needs | $1,236.52 | ↓ -67% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,313.52 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,637.44 | ↓ -56% |
| Highmark BCBS of PA | Managed Care | $1,759.17 | ↓ -53% |
| Cigna | New Business ASO | $2,132.48 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,193.00 | ↓ -42% |
| Cigna | Commercial | $2,508.80 | ↓ -33% |
| Health Plan of Upper Ohio Valley | Commercial | $2,897.66 | ↓ -23% |
| Highmark BCBS of PA | UPMC Emergent | $3,518.34 | ↓ -7% |
| Coventry/First Health | Commercial | $4,390.40 | ↑ +17% |
| InterGroup | PPO | $5,205.76 | ↑ +38% |
| Private Health Care Systems | PPO | $5,331.20 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $5,331.20 | ↑ +42% |
| Humana | Commercial | $5,331.20 | ↑ +42% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Sig w/tndsc balloon dilation at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $2,736.60 | $109.36 – $4,104.90 |
| UPMC Presbyterian | Pittsburgh | $9,642.00 | $109.36 – $13,659.50 |
| UPMC St. Margaret | Pittsburgh | $4,032.00 | $109.36 – $5,712.00 |
| UPMC Wellsboro | Wellsboro | $3,933.60 | $109.36 – $4,425.30 |
| UPMC Williamsport | Williamsport | $3,097.80 | $109.36 – $4,130.40 |