Unlisted procedure rectum at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$845.40
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.
?
What you pay up front if you don't use insurance.
$1,409.00
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.
$18.77 with Highmark BCBS of PA vs $1,197.65 with Multiplan — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | ↓ -98% |
| UPMC Health Plan | Commercial | $36.64 | ↓ -96% |
| Highmark BCBS of PA | Managed Care - Social Mission | $41.78 | ↓ -95% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $52.08 | ↓ -94% |
| Highmark BCBS of PA | Managed Care | $55.95 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Indemnity | $69.75 | ↓ -92% |
| Highmark BCBS of PA | UPMC Emergent | $111.91 | ↓ -87% |
| Cigna | New Business ASO | $479.06 | ↓ -43% |
| Cigna | Commercial | $563.60 | ↓ -33% |
| Health Plan of Upper Ohio Valley | Commercial | $650.96 | ↓ -23% |
| PA Health & Wellness | PA Medicaid HMO | $774.95 | ↓ -8% |
| UPMC Health Plan | Managed Medicare | $807.76 | ↓ -4% |
| Health Plan of Upper Ohio Valley | Medicaid | $869.21 | ↑ +3% |
| Health Plan of Upper Ohio Valley | Medicare | $869.21 | ↑ +3% |
| Aetna of PA | Medicare | $912.67 | ↑ +8% |
| United Healthcare | Unison Advantage Non Special Needs | $912.67 | ↑ +8% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↑ +11% |
| AmeriHealth Caritas | Medicare | $938.75 | ↑ +11% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↑ +11% |
| Aetna | Medicare | $956.13 | ↑ +13% |
| United Healthcare | Unison Advantage Special Needs | $956.13 | ↑ +13% |
| Coventry/First Health | Commercial | $986.30 | ↑ +17% |
| InterGroup | PPO | $1,169.47 | ↑ +38% |
| Private Health Care Systems | PPO | $1,197.65 | ↑ +42% |
| Humana | Commercial | $1,197.65 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $1,197.65 | ↑ +42% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Private Health Care Systems | Workers' Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Unlisted procedure rectum at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $554.40 | $18.77 – $956.13 |
| UPMC Mercy | Pittsburgh | $532.20 | $18.59 – $956.13 |
| UPMC Presbyterian | Pittsburgh | $585.00 | $18.77 – $956.13 |
| UPMC Altoona | Altoona | $121.80 | $18.59 – $938.75 |
| UPMC Bedford | Everett | $791.40 | $48.62 – $1,187.10 |
| UPMC East | Monroeville | $538.20 | $18.77 – $938.75 |
| UPMC Hamot | Erie | $515.40 | $18.59 – $1,264.19 |
| UPMC Jameson | New Castle | $131.40 | $18.92 – $1,173.43 |