▸ Hospital · PA · CCN 390107
UPMC Passavant
9100 BABCOCK BOULEVARD, PITTSBURGH, PA, 15237
365 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
162
of 209 target codes
Payers
15
with negotiated rates
Rates published
32,894
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 7 | — | — | $7,529.42 | $10,777 | $25,296 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 14 | $306 | $183.6 | $51.6 | $122.4 | $407.3 |
| ED visit level 2 | CPT | 99282 | 14 | $707 | $424.2 | $36.28 | $230.22 | $657.51 |
| ED visit level 3 | CPT | 99283 | 14 | $1,272 | $763.2 | $62.31 | $309.68 | $1,182.96 |
| ED visit level 4 | CPT | 99284 | 14 | $1,910 | $1,146 | $104.86 | $446.57 | $1,776.3 |
| ED visit level 5 | CPT | 99285 | 14 | $2,997 | $1,798.2 | $152.61 | $642.97 | $2,787.21 |
| Critical care, first hour | CPT | 99291 | 14 | $3,197 | $1,918.2 | $166.79 | $867.6 | $2,973.21 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 14 | $2,993 | $1,795.8 | $94.21 | $661.04 | $2,783.49 |
| CT head with contrast | CPT | 70460 | 14 | $4,424 | $2,654.4 | $147.4 | $785.33 | $4,114.32 |
| CT head with and without contrast | CPT | 70470 | 14 | $4,922 | $2,953.2 | $157.72 | $957.15 | $4,577.46 |
| CT neck with contrast | CPT | 70491 | 14 | $4,424 | $2,654.4 | $151.25 | $824.61 | $4,114.32 |
| MRI brain without contrast | CPT | 70551 | 15 | $6,336 | $3,801.6 | $214.16 | $1,354.22 | $5,892.48 |
| MRI brain with contrast | CPT | 70552 | 15 | $7,702 | $4,621.2 | $316.41 | $1,625.79 | $7,162.86 |
| MRI brain with and without contrast | CPT | 70553 | 15 | $9,999 | $5,999.4 | $316.41 | $2,869.54 | $9,299.07 |
| Chest X-ray single view | CPT | 71045 | 14 | $699 | $419.4 | $6.49 | $90.66 | $650.07 |
| Chest X-ray 2 views | CPT | 71046 | 14 | $699 | $419.4 | $11.9 | $90.66 | $650.07 |
| Chest X-ray 3 views | CPT | 71047 | 14 | $699 | $419.4 | $15.12 | $90.66 | $650.07 |
| CT chest without contrast | CPT | 71250 | 14 | $2,993 | $1,795.8 | $94.21 | $815.23 | $2,783.49 |
| CT chest with contrast | CPT | 71260 | 14 | $4,424 | $2,654.4 | $157.72 | $951.63 | $4,114.32 |
| CT chest with and without contrast | CPT | 71270 | 14 | $4,922 | $2,953.2 | $157.72 | $1,162.93 | $4,577.46 |
| MRI chest without contrast | CPT | 71550 | 15 | $6,336 | $3,801.6 | $214.16 | $1,373 | $5,892.48 |
| MRI chest with contrast | CPT | 71551 | 15 | $4,728 | $2,836.8 | $431.72 | $1,412.35 | $4,397.04 |
| MRI chest with and without contrast | CPT | 71552 | 15 | $9,999 | $5,999.4 | $316.41 | $2,278.92 | $9,299.07 |
| Lumbosacral spine X-ray | CPT | 72100 | 14 | $699 | $419.4 | $34.28 | $111.52 | $650.07 |
| CT cervical spine without contrast | CPT | 72125 | 14 | $2,993 | $1,795.8 | $94.21 | $815.23 | $2,783.49 |
| CT thoracic spine without contrast | CPT | 72128 | 14 | $2,993 | $1,795.8 | $94.21 | $815.23 | $2,783.49 |
| CT lumbar spine without contrast | CPT | 72131 | 14 | $2,993 | $1,795.8 | $94.21 | $815.23 | $2,783.49 |
| MRI cervical spine without contrast | CPT | 72141 | 15 | $6,336 | $3,801.6 | $214.16 | $1,373 | $5,892.48 |
| MRI thoracic spine without contrast | CPT | 72146 | 15 | $6,336 | $3,801.6 | $214.16 | $1,497.28 | $5,892.48 |
| MRI lumbar spine without contrast | CPT | 72148 | 15 | $6,336 | $3,801.6 | $214.16 | $1,478.45 | $5,892.48 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 15 | $7,702 | $4,621.2 | $316.41 | $1,625.79 | $7,162.86 |
| MRI cervical spine with and without contrast | CPT | 72156 | 15 | $9,999 | $5,999.4 | $316.41 | $2,898.99 | $9,299.07 |
| MRI lumbar spine with contrast | CPT | 72158 | 15 | $9,999 | $5,999.4 | $316.41 | $2,869.54 | $9,299.07 |
| CT pelvis without contrast | CPT | 72192 | 14 | $2,993 | $1,795.8 | $94.21 | $803.57 | $2,783.49 |
| CT pelvis with contrast | CPT | 72193 | 14 | $4,424 | $2,654.4 | $154.1 | $914.04 | $4,114.32 |
| Shoulder X-ray | CPT | 73030 | 14 | $699 | $419.4 | $28.58 | $133.09 | $650.07 |
| Humerus X-ray | CPT | 73060 | 14 | $699 | $419.4 | $28 | $133.16 | $650.07 |
| Hand X-ray 3 views | CPT | 73130 | 14 | $1,036 | $621.6 | $26.76 | $124.93 | $963.48 |
| MRI upper extremity joint without contrast | CPT | 73221 | 15 | $6,336 | $3,801.6 | $214.16 | $1,805.94 | $5,892.48 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 15 | $9,999 | $5,999.4 | $316.41 | $3,203.32 | $9,299.07 |
| Knee X-ray 1-2 views | CPT | 73560 | 14 | $699 | $419.4 | $30.17 | $121.86 | $650.07 |
| Ankle X-ray 3 views | CPT | 73610 | 14 | $699 | $419.4 | $26.25 | $124.93 | $650.07 |
| MRI lower extremity joint without contrast | CPT | 73721 | 15 | $6,336 | $3,801.6 | $214.16 | $1,805.94 | $5,892.48 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 15 | $9,999 | $5,999.4 | $316.41 | $3,203.32 | $9,299.07 |
| CT abdomen without contrast | CPT | 74150 | 14 | $2,993 | $1,795.8 | $94.21 | $793.5 | $2,783.49 |
| CT abdomen with contrast | CPT | 74160 | 14 | $4,424 | $2,654.4 | $157.72 | $931.86 | $4,114.32 |
| CT abdomen with and without contrast | CPT | 74170 | 14 | $4,922 | $2,953.2 | $157.72 | $1,129.95 | $4,577.46 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 14 | $6,326 | $3,795.6 | $185.12 | $1,066.48 | $5,883.18 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 14 | $9,061 | $5,436.6 | $289.48 | $1,233.18 | $8,426.73 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 14 | $9,061 | $5,436.6 | $316.41 | $1,486.28 | $8,426.73 |
| MRI abdomen without contrast | CPT | 74181 | 15 | $6,336 | $3,801.6 | $214.16 | $1,373 | $5,892.48 |
| MRI abdomen with and without contrast | CPT | 74183 | 15 | $9,999 | $5,999.4 | $316.41 | $2,293.29 | $9,299.07 |
| Abdominal ultrasound complete | CPT | 76700 | 14 | $3,476 | $2,085.6 | $94.21 | $343.34 | $3,232.68 |
| Abdominal ultrasound limited | CPT | 76705 | 14 | $1,733 | $1,039.8 | $68.75 | $254.92 | $1,611.69 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 14 | $2,449 | $1,469.4 | $89.65 | $332 | $2,277.57 |
| Obstetric ultrasound first trimester | CPT | 76801 | 14 | $678 | $406.8 | $92.5 | $230.52 | $853.43 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 14 | $2,558 | $1,534.8 | $85.25 | $389.05 | $2,378.94 |
| Transvaginal ultrasound | CPT | 76830 | 14 | $2,490 | $1,494 | $84.15 | $279.05 | $2,315.7 |
| Pelvic ultrasound complete | CPT | 76856 | 14 | $2,490 | $1,494 | $84.15 | $282.47 | $2,315.7 |
| Scrotal ultrasound | CPT | 76870 | 14 | $1,605 | $963 | $81.4 | $270.61 | $1,492.65 |
| Diagnostic mammography unilateral | CPT | 77065 | 13 | $712 | $427.2 | $58.27 | $284.8 | $662.16 |
| EKG tracing only | CPT | 93005 | 14 | $644 | $386.4 | $11.51 | $62.36 | $598.92 |
| Transthoracic echocardiogram complete | CPT | 93306 | 14 | $3,519 | $2,111.4 | $155.12 | $953.17 | $3,272.67 |
| Transthoracic echocardiogram | CPT | 93307 | 14 | $3,341 | $2,004.6 | $154.42 | $655.62 | $3,107.13 |
| Stress echocardiogram | CPT | 93350 | 14 | $1,741 | $1,044.6 | $84.15 | $591.94 | $1,619.13 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 9 | — | — | $7,529.42 | $15,515 | $66,137 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 9 | — | — | $6,064.23 | $7,866.89 | $41,547 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 9 | — | — | $4,889.16 | $5,573.65 | $32,456 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 9 | — | — | $7,529.42 | $12,057 | $50,969 |
| COPD w MCC | MS-DRG | 190 | 9 | — | — | $7,529.42 | $8,625.3 | $34,387 |
| COPD w CC | MS-DRG | 191 | 9 | — | — | $6,022.16 | $6,865.27 | $52,870 |
| COPD w/o CC/MCC | MS-DRG | 192 | 9 | — | — | $4,586.28 | $5,228.36 | $24,260 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 9 | — | — | $5,757.15 | $6,563.15 | $28,782 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 9 | — | — | $4,489.84 | $5,118.42 | $29,413 |
| AMI discharged alive w MCC | MS-DRG | 280 | 9 | — | — | $7,529.42 | $12,376 | $51,628 |
| AMI discharged alive w CC | MS-DRG | 281 | 9 | — | — | $5,198.93 | $7,222.39 | $35,612 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 9 | — | — | $4,267.82 | $5,682.2 | $32,126 |
| Heart failure & shock w MCC | MS-DRG | 291 | 9 | — | — | $6,106.11 | $9,996.55 | $39,899 |
| Heart failure & shock w CC | MS-DRG | 292 | 9 | — | — | $6,065.05 | $6,914.16 | $32,550 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 9 | — | — | $4,043.37 | $4,609.45 | $24,354 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 9 | — | — | $7,529.42 | $9,461.18 | $37,025 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 9 | — | — | $5,255.64 | $5,991.43 | $23,317 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 9 | — | — | $4,044.08 | $4,610.25 | $18,230 |
| GI hemorrhage w CC | MS-DRG | 378 | 9 | — | — | $7,005.87 | $7,706.46 | $36,272 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 9 | — | — | $3,834.57 | $4,953.77 | $25,579 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 9 | — | — | $5,569.27 | $6,348.97 | $38,323 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 7 | — | — | $7,529.42 | $12,207 | $71,978 |
| Kidney/UTI w MCC | MS-DRG | 689 | 7 | — | — | $7,529.42 | $9,034.89 | $42,961 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | — | — | $5,782.87 | $6,361.16 | $23,506 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 7 | — | — | $7,529.42 | $15,126 | $66,043 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 7 | — | — | $7,310.19 | $7,968.11 | $33,728 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 14 | $338 | $202.8 | $7.86 | $118.3 | $314.34 |
| Electrolyte panel | CPT | 80051 | 14 | $275 | $165 | $6.51 | $31.58 | $255.75 |
| Comprehensive metabolic panel | CPT | 80053 | 14 | $470 | $282 | $9.81 | $164.5 | $437.1 |
| Lipid panel | CPT | 80061 | 14 | $504 | $302.4 | $12.44 | $47.74 | $468.72 |
| Renal function panel | CPT | 80069 | 14 | $354 | $212.4 | $8.07 | $40.41 | $329.22 |
| Hepatic function panel | CPT | 80076 | 14 | $335 | $201 | $7.59 | $117.25 | $311.55 |
| Urinalysis non-automated | CPT | 81002 | 14 | $45 | $27 | $3.23 | $12.19 | $41.85 |
| Urinalysis automated | CPT | 81003 | 14 | $119 | $71.4 | $2.09 | $10.72 | $110.67 |
| Glucose quantitative | CPT | 82947 | 14 | $205 | $123 | $3.65 | $13.33 | $190.65 |
| Hemoglobin A1c | CPT | 83036 | 14 | $394 | $236.4 | $7.7 | $36.11 | $366.42 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 14 | $668 | $400.8 | $15.61 | $232.56 | $621.24 |
| Complete blood count with automated differential | CPT | 85025 | 14 | $392 | $235.2 | $6.6 | $26.33 | $364.56 |
| Complete blood count without differential | CPT | 85027 | 14 | $245 | $147 | $6.01 | $21.93 | $227.85 |
| Urine culture bacterial | CPT | 87086 | 14 | $426 | $255.6 | $7.5 | $149.22 | $396.18 |
| Urine culture identification | CPT | 87088 | 14 | $128 | $76.8 | $7.52 | $27.41 | $119.04 |
| Tissue exam by pathologist level IV | CPT | 88305 | 14 | $575 | $345 | $27.79 | $201.61 | $534.75 |
| maternity | ||||||||
| Vaginal delivery only | CPT | 59409 | 14 | $12,201 | $7,320.6 | $619.68 | $4,100.4 | $11,347 |
| Vaginal delivery with postpartum | CPT | 59410 | 12 | $5,461 | $3,276.6 | $1,365.25 | $3,822.7 | $9,896.87 |
| C-section with postpartum | CPT | 59515 | 12 | $6,507 | $3,904.2 | $1,626.75 | $4,554.9 | $11,794 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 14 | $306 | $183.6 | $36.08 | $131.41 | $348.23 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 14 | $398 | $238.8 | $36.08 | $169.32 | $448.71 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 14 | $505 | $303 | $36.08 | $233.31 | $558.02 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 14 | $1,106 | $663.6 | $36.08 | $335.1 | $1,028.58 |
| Office visit, established patient, 5 min | CPT | 99211 | 14 | $181 | $108.6 | $22 | $72.4 | $168.33 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 14 | $209 | $125.4 | $28.6 | $83.6 | $205.79 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 14 | $299 | $179.4 | $36.08 | $119.6 | $278.07 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 14 | $418 | $250.8 | $36.08 | $159.62 | $388.74 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 14 | $955 | $573 | $36.08 | $245.72 | $888.15 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 14 | $3,159 | $1,895.4 | $137.74 | $1,074.06 | $3,281.43 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 14 | $3,690 | $2,214 | $163.44 | $1,254.6 | $4,393.81 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 14 | $997 | $598.2 | $58.47 | $847.45 | $2,014.38 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 14 | $2,981 | $1,788.6 | $70.04 | $1,013.54 | $3,281.43 |
| Colonoscopy diagnostic | CPT | 45378 | 14 | $2,809 | $1,685.4 | $198.55 | $1,139.3 | $4,393.81 |
| Colonoscopy with biopsy | CPT | 45380 | 14 | $3,690 | $2,214 | $247.96 | $1,254.6 | $4,393.81 |
| Colonoscopy with polyp removal | CPT | 45385 | 14 | $7,842 | $4,705.2 | $294.89 | $1,640.37 | $7,293.06 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 9 | — | — | $2,642.84 | $16,293 | $19,286 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 2 | — | — | $6,617.15 | $8,454.85 | $10,293 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 2 | — | — | $6,620.74 | $8,456.65 | $10,293 |
| Total hip replacement | CPT | 27130 | 9 | — | — | $2,492.82 | $12,267 | $19,556 |
| Total knee replacement | CPT | 27447 | 9 | — | — | $2,690.84 | $12,267 | $19,556 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 4 | — | — | $844.93 | $2,462.16 | $5,038.97 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | — | — | $1,274.16 | $6,810.69 | $7,598.8 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 9 | — | — | $5,135.5 | $35,463 | $135,665 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 9 | — | — | $3,474.33 | $18,495 | $83,425 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 9 | — | — | $7,529.42 | $12,984 | $62,698 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 9 | — | — | $7,529.42 | $13,051 | $60,107 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 9 | — | — | $7,529.42 | $10,635 | $49,979 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 9 | — | — | $7,529.42 | $26,287 | $157,428 |
| Open appendectomy | CPT | 44950 | 9 | — | — | $1,210.25 | $5,948.85 | $9,822.12 |
| Laparoscopic appendectomy | CPT | 44970 | 9 | — | — | $1,067.82 | $5,562.36 | $9,822.12 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 2 | — | — | $10,293 | $15,644 | $20,996 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 2 | — | — | $10,293 | $11,144 | $11,996 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $10,293 | $23,835 | $104,622 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $10,293 | $15,158 | $56,810 |
| Laparoscopic cholecystectomy | CPT | 47562 | 9 | — | — | $1,414.39 | $5,562.36 | $9,822.12 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 9 | — | — | $10,293 | $22,885 | $218,514 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 9 | — | — | $10,293 | $16,459 | $183,203 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 9 | — | — | $10,293 | $12,817 | $61,002 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 11 | $8,296 | $4,977.6 | $1,469.67 | $4,148 | $7,715.28 |
| Lap inguinal hernia repair | CPT | 49650 | 9 | — | — | $818.32 | $5,562.36 | $6,206.98 |
| Total abdominal hysterectomy | CPT | 58150 | 4 | — | — | $1,673.37 | $3,725.73 | $9,979.57 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 7 | — | — | $7,529.42 | $22,483 | $103,068 |
| OR procedure for obesity w CC | MS-DRG | 620 | 7 | — | — | $7,529.42 | $12,461 | $60,154 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 7 | — | — | $7,529.42 | $11,745 | $48,566 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 7 | — | — | $7,529.42 | $9,660.92 | $41,123 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 7 | — | — | $7,529.42 | $15,956 | $48,001 |
| PCI single major coronary artery | CPT | 92920 | 14 | $28,986 | $17,392 | $773.91 | $7,333.66 | $26,957 |
| PCI with drug-eluting stent | CPT | 92928 | 14 | $44,026 | $26,416 | $859.73 | $13,002 | $40,944 |
| Left heart catheterization | CPT | 93452 | 14 | $23,070 | $13,842 | $1,056.32 | $4,969.8 | $21,455 |
| Coronary angiography with cath | CPT | 93455 | 14 | $17,248 | $10,349 | $1,289.74 | $5,759.92 | $16,041 |
| Coronary angiography with bypass cath | CPT | 93458 | 14 | $31,252 | $18,751 | $1,321.51 | $7,236.31 | $29,064 |
Payer mix (top 15)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 158 | $1,056.67 |
| upmc health plan | 158 | $393.98 |
| Aetna | 156 | $366.02 |
| pa health & wellness | 156 | $258.41 |
| health plan of upper ohio valley | 156 | $1,124.11 |
| UnitedHealthcare | 153 | $253.5 |
| amerihealth caritas | 153 | $248.29 |
| upmc work partners | 149 | $859.73 |
| private health care systems | 149 | $1,479.85 |
| intergroup | 105 | $2,402.85 |
| Cigna | 105 | $1,015.58 |
| Humana | 105 | $2,460.75 |
| First Health | 105 | $1,966.3 |
| Multiplan | 105 | $2,460.75 |
| premier comp solutions | 18 | $1,321.86 |