Whfo nontorsion joint prefab at UPMC Passavant-McCandless
9100 Babcock Boulevard, Pittsburgh, PA · UPMC · · NPI 1225047699
$381.60
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.
$636.00
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.
$139.92 with Highmark Wholecare (prev Gateway) vs $1,985.86 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $139.92 | ↓ -63% |
| Aetna | Medicare | $159.00 | ↓ -58% |
| Cigna | New Business ASO | $216.24 | ↓ -43% |
| UPMC Work Partners | Workers Comp | $233.39 | ↓ -39% |
| Cigna | Commercial | $254.40 | ↓ -33% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $269.99 | ↓ -29% |
| Private Health Care Systems | Workers' Comp | $271.38 | ↓ -29% |
| Health Plan of Upper Ohio Valley | Commercial | $293.83 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $318.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $349.80 | ↓ -8% |
| Coventry/First Health | Commercial | $445.20 | ↑ +17% |
| InterGroup | PPO | $527.88 | ↑ +38% |
| Multiplan | PPO (Includes Workers' Comp) | $540.60 | ↑ +42% |
| Humana | Commercial | $540.60 | ↑ +42% |
| Private Health Care Systems | PPO | $540.60 | ↑ +42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $741.37 | ↑ +94% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $749.37 | ↑ +96% |
| Highmark BCBS of PA | Managed Care | $992.93 | ↑ +160% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,003.62 | ↑ +163% |
| UPMC Health Plan | Commercial | $1,167.91 | ↑ +206% |
| Highmark BCBS of PA | UPMC Emergent | $1,985.86 | ↑ +420% |
Visitor-reported prices
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Whfo nontorsion joint prefab at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $165.60 | $106.49 – $804.83 |
| UPMC Mercy | Pittsburgh | $176.40 | $233.39 – $635.53 |
| UPMC Presbyterian | Pittsburgh | $354.00 | $138.12 – $1,301.27 |
| UPMC St. Margaret | Pittsburgh | $349.80 | $233.39 – $987.59 |
| UPMC Altoona | Altoona | $159.00 | $50.35 – $804.83 |
| UPMC Bedford | Everett | $585.60 | $180.12 – $853.20 |
| UPMC Cole | Coudersport | $670.80 | $212.42 – $894.40 |
| UPMC East | Monroeville | $201.60 | $16.72 – $804.83 |