healthcosts.net
Vaccine influenza quadrivalent (iiv4) split virus 0.25 ml im at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$15.00
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.
$25.00
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.
$6.25 with Aetna vs $127.67 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 |
|---|---|---|---|
| Aetna | Medicare | $6.25 | ↓ -58% |
| Cigna | New Business ASO | $8.50 | ↓ -43% |
| UPMC Work Partners | Workers Comp | $9.00 | ↓ -40% |
| Cigna | Commercial | $10.00 | ↓ -33% |
| Private Health Care Systems | Workers' Comp | $10.46 | ↓ -30% |
| UPMC Health Plan | Commercial | $10.56 | ↓ -30% |
| UPMC Health Plan | Managed Medicaid | $11.00 | ↓ -27% |
| United Healthcare Community Plan for Families | Unison Kids | $11.50 | ↓ -23% |
| Health Plan of Upper Ohio Valley | Commercial | $11.55 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.50 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.83 | ↓ -1% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.61 | ↑ +4% |
| PA Health & Wellness | PA Medicaid HMO | $17.04 | ↑ +14% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $17.36 | ↑ +16% |
| Coventry/First Health | Commercial | $17.50 | ↑ +17% |
| InterGroup | PPO | $20.75 | ↑ +38% |
| Humana | Commercial | $21.25 | ↑ +42% |
| Multiplan | PPO (Includes Workers' Comp) | $21.25 | ↑ +42% |
| Private Health Care Systems | PPO | $21.25 | ↑ +42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $47.66 | ↑ +218% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $48.18 | ↑ +221% |
| Highmark BCBS of PA | Managed Care | $63.84 | ↑ +326% |
| Highmark BCBS of PA | Commercial - Indemnity | $64.52 | ↑ +330% |
| Highmark BCBS of PA | UPMC Emergent | $127.67 | ↑ +751% |