healthcosts.net
Stent/tib/peroneal/unilat/initial 37230 at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$34,695.00
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.
$57,825.00
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.
$12,299.12 with UPMC Work Partners vs $90,199.80 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $12,299.12 | ↓ -65% |
| Private Health Care Systems | Workers' Comp | $14,301.30 | ↓ -59% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $15,124.65 | ↓ -56% |
| UPMC Health Plan | Managed Medicare | $15,909.23 | ↓ -54% |
| Health Plan of Upper Ohio Valley | Medicaid | $17,119.58 | ↓ -51% |
| Health Plan of Upper Ohio Valley | Medicare | $17,119.58 | ↓ -51% |
| Aetna of PA | Medicare | $17,975.56 | ↓ -48% |
| United Healthcare | Unison Advantage Non Special Needs | $17,975.56 | ↓ -48% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,487.43 | ↓ -47% |
| AmeriHealth Caritas | Medicare | $18,489.15 | ↓ -47% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,489.15 | ↓ -47% |
| Aetna | Medicare | $18,831.54 | ↓ -46% |
| United Healthcare | Unison Advantage Special Needs | $18,831.54 | ↓ -46% |
| Cigna | New Business ASO | $19,660.50 | ↓ -43% |
| Cigna | Commercial | $23,130.00 | ↓ -33% |
| UPMC Health Plan | Commercial | $24,425.28 | ↓ -30% |
| Health Plan of Upper Ohio Valley | Commercial | $26,715.15 | ↓ -23% |
| PA Health & Wellness | PA Medicaid HMO | $31,803.75 | ↓ -8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $33,674.81 | ↓ -3% |
| Coventry/First Health | Commercial | $40,477.50 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $41,979.05 | ↑ +21% |
| Highmark BCBS of PA | Managed Care | $45,099.90 | ↑ +30% |
| InterGroup | PPO | $47,994.75 | ↑ +38% |
| Humana | Commercial | $49,151.25 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $49,151.25 | ↑ +42% |
| Private Health Care Systems | PPO | $49,151.25 | ↑ +42% |
| Highmark BCBS of PA | Commercial - Indemnity | $56,221.93 | ↑ +62% |
| Highmark BCBS of PA | UPMC Emergent | $90,199.80 | ↑ +160% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Stent/tib/peroneal/unilat/initial 37230 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $40,886.40 | $644.90 – $57,922.40 |
| UPMC Somerset | Somerset | $24,161.40 | $892.40 – $30,201.75 |