Does UPMC Passavant publish its standard charges and chargemaster?

Yes. UPMC Passavant publishes a machine-readable file with 32,894 standard-charge rows — gross charges, cash prices, and payer-negotiated rates, earning a CMS price transparency compliance grade of A. Browse the negotiated rates by procedure and payer on this page.

How much does UPMC Passavant charge for procedures?

UPMC Passavant (Pittsburgh, PA) publishes a separately negotiated rate for each insurance payer, plus a discounted cash price and a gross (list) charge, for every procedure in its price transparency file. This page compares each procedure's negotiated median against the national median so you can see whether a price is above or below market.

▸ Hospital · PA · CCN 390107

UPMC Passavant

Pittsburgh, PA, 15237

365 bedsAcute Care Hospitals2

Compliance grade

100/100

Rates published

32,894

last crawl 2026-05-24

Procedures tracked

162

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All PA hospitalsJSON

The report bundles all published codes × every payer rate + compliance grade as a downloadable PDF + CSV with a data-version manifest.

Source MRF: https://dam.upmc.com/-/media/upmc/locations/hospitals/documents/cdm-json-files/250965451_upmc-passavant_standardcharges.csv? · CSV

Procedures & rates

vs nat'l shows this hospital's negotiated median against the national median for that code (green = at/below market, amber = 1–1.5×, red = >1.5× the national median).

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	vs nat'l	Neg max
behavioral
Psychoses	MS-DRG	885	7	—	—	$7,529.42	$10,777	0.84×	$25,296
emergency
ED visit level 1	CPT	99281	14	$306	$183.6	$51.6	$122.4	0.87×	$407.3
ED visit level 2	CPT	99282	14	$707	$424.2	$36.28	$230.22	0.97×	$657.51
ED visit level 3	CPT	99283	14	$1,272	$763.2	$62.31	$309.68	0.76×	$1,182.96
ED visit level 4	CPT	99284	14	$1,910	$1,146	$104.86	$446.57	0.67×	$1,776.3
ED visit level 5	CPT	99285	14	$2,997	$1,798.2	$152.61	$642.97	0.62×	$2,787.21
Critical care, first hour	CPT	99291	14	$3,197	$1,918.2	$166.79	$867.6	0.81×	$2,973.21
imaging
CT head without contrast	CPT	70450	14	$2,993	$1,795.8	$94.21	$661.04	3.2×	$2,783.49
CT head with contrast	CPT	70460	14	$4,424	$2,654.4	$147.4	$785.33	3.4×	$4,114.32
CT head with and without contrast	CPT	70470	14	$4,922	$2,953.2	$157.72	$957.15	3.6×	$4,577.46
CT neck with contrast	CPT	70491	14	$4,424	$2,654.4	$151.25	$824.61	3.0×	$4,114.32
MRI brain without contrast	CPT	70551	15	$6,336	$3,801.6	$214.16	$1,354.22	3.4×	$5,892.48
MRI brain with contrast	CPT	70552	15	$7,702	$4,621.2	$316.41	$1,625.79	3.4×	$7,162.86
MRI brain with and without contrast	CPT	70553	15	$9,999	$5,999.4	$316.41	$2,869.54	4.9×	$9,299.07
Chest X-ray single view	CPT	71045	14	$699	$419.4	$6.49	$90.66	0.96×	$650.07
Chest X-ray 2 views	CPT	71046	14	$699	$419.4	$11.9	$90.66	0.92×	$650.07
Chest X-ray 3 views	CPT	71047	14	$699	$419.4	$15.12	$90.66	0.95×	$650.07
CT chest without contrast	CPT	71250	14	$2,993	$1,795.8	$94.21	$815.23	3.8×	$2,783.49
CT chest with contrast	CPT	71260	14	$4,424	$2,654.4	$157.72	$951.63	3.4×	$4,114.32
CT chest with and without contrast	CPT	71270	14	$4,922	$2,953.2	$157.72	$1,162.93	4.0×	$4,577.46
MRI chest without contrast	CPT	71550	15	$6,336	$3,801.6	$214.16	$1,373	3.2×	$5,892.48
MRI chest with contrast	CPT	71551	15	$4,728	$2,836.8	$431.72	$1,412.35	1.7×	$4,397.04
MRI chest with and without contrast	CPT	71552	15	$9,999	$5,999.4	$316.41	$2,278.92	3.8×	$9,299.07
Lumbosacral spine X-ray	CPT	72100	14	$699	$419.4	$34.28	$111.52	1.1×	$650.07
CT cervical spine without contrast	CPT	72125	14	$2,993	$1,795.8	$94.21	$815.23	4.0×	$2,783.49
CT thoracic spine without contrast	CPT	72128	14	$2,993	$1,795.8	$94.21	$815.23	4.1×	$2,783.49
CT lumbar spine without contrast	CPT	72131	14	$2,993	$1,795.8	$94.21	$815.23	4.0×	$2,783.49
MRI cervical spine without contrast	CPT	72141	15	$6,336	$3,801.6	$214.16	$1,373	3.5×	$5,892.48
MRI thoracic spine without contrast	CPT	72146	15	$6,336	$3,801.6	$214.16	$1,497.28	4.0×	$5,892.48
MRI lumbar spine without contrast	CPT	72148	15	$6,336	$3,801.6	$214.16	$1,478.45	3.9×	$5,892.48
MRI lumbar spine with and without contrast	CPT	72149	15	$7,702	$4,621.2	$316.41	$1,625.79	3.6×	$7,162.86
MRI cervical spine with and without contrast	CPT	72156	15	$9,999	$5,999.4	$316.41	$2,898.99	5.4×	$9,299.07
MRI lumbar spine with contrast	CPT	72158	15	$9,999	$5,999.4	$316.41	$2,869.54	5.2×	$9,299.07
CT pelvis without contrast	CPT	72192	14	$2,993	$1,795.8	$94.21	$803.57	4.0×	$2,783.49
CT pelvis with contrast	CPT	72193	14	$4,424	$2,654.4	$154.1	$914.04	3.2×	$4,114.32
Shoulder X-ray	CPT	73030	14	$699	$419.4	$28.58	$133.09	1.4×	$650.07
Humerus X-ray	CPT	73060	14	$699	$419.4	$28	$133.16	1.5×	$650.07
Hand X-ray 3 views	CPT	73130	14	$1,036	$621.6	$26.76	$124.93	1.3×	$963.48
MRI upper extremity joint without contrast	CPT	73221	15	$6,336	$3,801.6	$214.16	$1,805.94	4.3×	$5,892.48
MRI upper extremity joint with and without contrast	CPT	73223	15	$9,999	$5,999.4	$316.41	$3,203.32	5.2×	$9,299.07
Knee X-ray 1-2 views	CPT	73560	14	$699	$419.4	$30.17	$121.86	1.3×	$650.07
Ankle X-ray 3 views	CPT	73610	14	$699	$419.4	$26.25	$124.93	1.4×	$650.07
MRI lower extremity joint without contrast	CPT	73721	15	$6,336	$3,801.6	$214.16	$1,805.94	3.9×	$5,892.48
MRI lower extremity joint with and without contrast	CPT	73723	15	$9,999	$5,999.4	$316.41	$3,203.32	5.1×	$9,299.07
CT abdomen without contrast	CPT	74150	14	$2,993	$1,795.8	$94.21	$793.5	4.2×	$2,783.49
CT abdomen with contrast	CPT	74160	14	$4,424	$2,654.4	$157.72	$931.86	3.2×	$4,114.32
CT abdomen with and without contrast	CPT	74170	14	$4,922	$2,953.2	$157.72	$1,129.95	3.4×	$4,577.46
CT abdomen and pelvis without contrast	CPT	74176	14	$6,326	$3,795.6	$185.12	$1,066.48	2.9×	$5,883.18
CT abdomen and pelvis with contrast	CPT	74177	14	$9,061	$5,436.6	$289.48	$1,233.18	2.2×	$8,426.73
CT abdomen and pelvis with and without contrast	CPT	74178	14	$9,061	$5,436.6	$316.41	$1,486.28	2.6×	$8,426.73
MRI abdomen without contrast	CPT	74181	15	$6,336	$3,801.6	$214.16	$1,373	3.5×	$5,892.48
MRI abdomen with and without contrast	CPT	74183	15	$9,999	$5,999.4	$316.41	$2,293.29	4.0×	$9,299.07
Abdominal ultrasound complete	CPT	76700	14	$3,476	$2,085.6	$94.21	$343.34	2.3×	$3,232.68
Abdominal ultrasound limited	CPT	76705	14	$1,733	$1,039.8	$68.75	$254.92	1.7×	$1,611.69
Retroperitoneal ultrasound complete	CPT	76770	14	$2,449	$1,469.4	$89.65	$332	2.3×	$2,277.57
Obstetric ultrasound first trimester	CPT	76801	14	$678	$406.8	$92.5	$230.52	1.6×	$853.43
Obstetric ultrasound after first trimester	CPT	76805	14	$2,558	$1,534.8	$85.25	$389.05	2.5×	$2,378.94
Transvaginal ultrasound	CPT	76830	14	$2,490	$1,494	$84.15	$279.05	1.9×	$2,315.7
Pelvic ultrasound complete	CPT	76856	14	$2,490	$1,494	$84.15	$282.47	2.0×	$2,315.7
Scrotal ultrasound	CPT	76870	14	$1,605	$963	$81.4	$270.61	2.1×	$1,492.65
Diagnostic mammography unilateral	CPT	77065	13	$712	$427.2	$58.27	$284.8	1.9×	$662.16
EKG tracing only	CPT	93005	14	$644	$386.4	$11.51	$62.36	0.53×	$598.92
Transthoracic echocardiogram complete	CPT	93306	14	$3,519	$2,111.4	$155.12	$953.17	1.6×	$3,272.67
Transthoracic echocardiogram	CPT	93307	14	$3,341	$2,004.6	$154.42	$655.62	2.7×	$3,107.13
Stress echocardiogram	CPT	93350	14	$1,741	$1,044.6	$84.15	$591.94	1.2×	$1,619.13
inpatient
Intracranial hemorrhage/CVA w MCC	MS-DRG	064	9	—	—	$7,529.42	$15,515	0.77×	$66,137
Intracranial hemorrhage/CVA w CC	MS-DRG	065	9	—	—	$6,064.23	$7,866.89	0.73×	$41,547
Intracranial hemorrhage/CVA w/o CC/MCC	MS-DRG	066	9	—	—	$4,889.16	$5,573.65	0.73×	$32,456
Respiratory infections & inflammations w MCC	MS-DRG	177	9	—	—	$7,529.42	$12,057	0.78×	$50,969
COPD w MCC	MS-DRG	190	9	—	—	$7,529.42	$8,625.3	0.77×	$34,387
COPD w CC	MS-DRG	191	9	—	—	$6,022.16	$6,865.27	0.78×	$52,870
COPD w/o CC/MCC	MS-DRG	192	9	—	—	$4,586.28	$5,228.36	0.75×	$24,260
Simple pneumonia & pleurisy w CC	MS-DRG	194	9	—	—	$5,757.15	$6,563.15	0.77×	$28,782
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	9	—	—	$4,489.84	$5,118.42	0.77×	$29,413
AMI discharged alive w MCC	MS-DRG	280	9	—	—	$7,529.42	$12,376	0.79×	$51,628
AMI discharged alive w CC	MS-DRG	281	9	—	—	$5,198.93	$7,222.39	0.75×	$35,612
AMI discharged alive w/o CC/MCC	MS-DRG	282	9	—	—	$4,267.82	$5,682.2	0.73×	$32,126
Heart failure & shock w MCC	MS-DRG	291	9	—	—	$6,106.11	$9,996.55	0.78×	$39,899
Heart failure & shock w CC	MS-DRG	292	9	—	—	$6,065.05	$6,914.16	0.77×	$32,550
Heart failure & shock w/o CC/MCC	MS-DRG	293	9	—	—	$4,043.37	$4,609.45	0.74×	$24,354
Cardiac arrhythmia w MCC	MS-DRG	308	9	—	—	$7,529.42	$9,461.18	0.78×	$37,025
Cardiac arrhythmia w CC	MS-DRG	309	9	—	—	$5,255.64	$5,991.43	0.77×	$23,317
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	9	—	—	$4,044.08	$4,610.25	0.74×	$18,230
GI hemorrhage w CC	MS-DRG	378	9	—	—	$7,005.87	$7,706.46	0.77×	$36,272
GI hemorrhage w/o CC/MCC	MS-DRG	379	9	—	—	$3,834.57	$4,953.77	0.72×	$25,579
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	9	—	—	$5,569.27	$6,348.97	0.79×	$38,323
Fractures of femur w/o MCC	MS-DRG	533	7	—	—	$7,529.42	$12,207	0.80×	$71,978
Kidney/UTI w MCC	MS-DRG	689	7	—	—	$7,529.42	$9,034.89	0.78×	$42,961
Kidney/UTI w/o MCC	MS-DRG	690	7	—	—	$5,782.87	$6,361.16	0.77×	$23,506
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	7	—	—	$7,529.42	$15,126	0.81×	$66,043
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	7	—	—	$7,310.19	$7,968.11	0.77×	$33,728
lab
Basic metabolic panel (BMP)	CPT	80048	14	$338	$202.8	$7.86	$118.3	3.7×	$314.34
Electrolyte panel	CPT	80051	14	$275	$165	$6.51	$31.58	1.3×	$255.75
Comprehensive metabolic panel	CPT	80053	14	$470	$282	$9.81	$164.5	3.7×	$437.1
Lipid panel	CPT	80061	14	$504	$302.4	$12.44	$47.74	1.3×	$468.72
Renal function panel	CPT	80069	14	$354	$212.4	$8.07	$40.41	1.5×	$329.22
Hepatic function panel	CPT	80076	14	$335	$201	$7.59	$117.25	4.4×	$311.55
Urinalysis non-automated	CPT	81002	14	$45	$27	$3.23	$12.19	1.8×	$41.85
Urinalysis automated	CPT	81003	14	$119	$71.4	$2.09	$10.72	0.77×	$110.67
Glucose quantitative	CPT	82947	14	$205	$123	$3.65	$13.33	0.76×	$190.65
Hemoglobin A1c	CPT	83036	14	$394	$236.4	$7.7	$36.11	1.3×	$366.42
Thyroid stimulating hormone (TSH)	CPT	84443	14	$668	$400.8	$15.61	$232.56	4.9×	$621.24
Complete blood count with automated differential	CPT	85025	14	$392	$235.2	$6.6	$26.33	0.99×	$364.56
Complete blood count without differential	CPT	85027	14	$245	$147	$6.01	$21.93	1.0×	$227.85
Urine culture bacterial	CPT	87086	14	$426	$255.6	$7.5	$149.22	6.4×	$396.18
Urine culture identification	CPT	87088	14	$128	$76.8	$7.52	$27.41	1.2×	$119.04
Tissue exam by pathologist level IV	CPT	88305	14	$575	$345	$27.79	$201.61	2.0×	$534.75
maternity
Vaginal delivery only	CPT	59409	14	$12,201	$7,320.6	$619.68	$4,100.4	1.9×	$11,347
Vaginal delivery with postpartum	CPT	59410	12	$5,461	$3,276.6	$1,365.25	$3,822.7	3.6×	$9,896.87
C-section with postpartum	CPT	59515	12	$6,507	$3,904.2	$1,626.75	$4,554.9	3.6×	$11,794
office
Office visit, new patient, 15-29 min	CPT	99202	14	$306	$183.6	$36.08	$131.41	1.5×	$348.23
Office visit, new patient, 30-44 minutes	CPT	99203	14	$398	$238.8	$36.08	$169.32	1.4×	$448.71
Office visit, new patient, 45-59 min	CPT	99204	14	$505	$303	$36.08	$233.31	1.3×	$558.02
Office visit, new patient, 60-74 min	CPT	99205	14	$1,106	$663.6	$36.08	$335.1	1.5×	$1,028.58
Office visit, established patient, 5 min	CPT	99211	14	$181	$108.6	$22	$72.4	1.1×	$168.33
Office visit, established patient, 10-19 min	CPT	99212	14	$209	$125.4	$28.6	$83.6	1.0×	$205.79
Office visit, established patient, 20-29 minutes	CPT	99213	14	$299	$179.4	$36.08	$119.6	1.0×	$278.07
Office visit, established patient, 30-39 minutes	CPT	99214	14	$418	$250.8	$36.08	$159.62	1.0×	$388.74
Office visit, established patient, 40-54 min	CPT	99215	14	$955	$573	$36.08	$245.72	1.3×	$888.15
preventive
Upper GI endoscopy diagnostic	CPT	43235	14	$3,159	$1,895.4	$137.74	$1,074.06	1.2×	$3,281.43
Upper GI endoscopy with biopsy	CPT	43239	14	$3,690	$2,214	$163.44	$1,254.6	1.3×	$4,393.81
Sigmoidoscopy diagnostic	CPT	45330	14	$997	$598.2	$58.47	$847.45	1.0×	$2,014.38
Sigmoidoscopy with biopsy	CPT	45331	14	$2,981	$1,788.6	$70.04	$1,013.54	1.1×	$3,281.43
Colonoscopy diagnostic	CPT	45378	14	$2,809	$1,685.4	$198.55	$1,139.3	1.3×	$4,393.81
Colonoscopy with biopsy	CPT	45380	14	$3,690	$2,214	$247.96	$1,254.6	1.0×	$4,393.81
Colonoscopy with polyp removal	CPT	45385	14	$7,842	$4,705.2	$294.89	$1,640.37	1.4×	$7,293.06
surgery
Total shoulder arthroplasty	CPT	23472	9	—	—	$2,642.84	$16,293	3.9×	$19,286
PCI w drug-eluting stent w MCC	MS-DRG	246	2	—	—	$6,617.15	$8,454.85	0.31×	$10,293
PCI w drug-eluting stent w/o MCC	MS-DRG	247	2	—	—	$6,620.74	$8,456.65	0.46×	$10,293
Total hip replacement	CPT	27130	9	—	—	$2,492.82	$12,267	2.8×	$19,556
Total knee replacement	CPT	27447	9	—	—	$2,690.84	$12,267	2.9×	$19,556
Shoulder arthroscopy with decompression	CPT	29826	4	—	—	$844.93	$2,462.16	7.5×	$5,038.97
Shoulder arthroscopy with rotator cuff repair	CPT	29827	9	—	—	$1,274.16	$6,810.69	2.1×	$7,598.8
Major small/large bowel procedures w MCC	MS-DRG	329	9	—	—	$5,135.5	$35,463	0.82×	$135,665
Major small/large bowel procedures w CC	MS-DRG	330	9	—	—	$3,474.33	$18,495	0.80×	$83,425
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	9	—	—	$7,529.42	$12,984	0.79×	$62,698
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	9	—	—	$7,529.42	$13,051	0.79×	$60,107
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	9	—	—	$7,529.42	$10,635	0.79×	$49,979
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	9	—	—	$7,529.42	$26,287	0.81×	$157,428
Open appendectomy	CPT	44950	9	—	—	$1,210.25	$5,948.85	5.2×	$9,822.12
Laparoscopic appendectomy	CPT	44970	9	—	—	$1,067.82	$5,562.36	3.6×	$9,822.12
Spinal fusion (non-cervical) w MCC	MS-DRG	459	2	—	—	$10,293	$15,644	0.32×	$20,996
Spinal fusion (non-cervical) w/o MCC	MS-DRG	460	2	—	—	$10,293	$11,144	0.33×	$11,996
Major joint replacement w MCC	MS-DRG	469	8	—	—	$10,293	$23,835	0.81×	$104,622
Major joint replacement w/o MCC	MS-DRG	470	8	—	—	$10,293	$15,158	0.80×	$56,810
Laparoscopic cholecystectomy	CPT	47562	9	—	—	$1,414.39	$5,562.36	3.1×	$9,822.12
Hip & femur procedures except major joint w MCC	MS-DRG	480	9	—	—	$10,293	$22,885	0.82×	$218,514
Hip & femur procedures except major joint w CC	MS-DRG	481	9	—	—	$10,293	$16,459	0.81×	$183,203
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	9	—	—	$10,293	$12,817	0.80×	$61,002
Umbilical hernia repair age 5+	CPT	49585	11	$8,296	$4,977.6	$1,469.67	$4,148	3.2×	$7,715.28
Lap inguinal hernia repair	CPT	49650	9	—	—	$818.32	$5,562.36	4.9×	$6,206.98
Total abdominal hysterectomy	CPT	58150	4	—	—	$1,673.37	$3,725.73	3.8×	$9,979.57
OR procedure for obesity w MCC	MS-DRG	619	7	—	—	$7,529.42	$22,483	0.83×	$103,068
OR procedure for obesity w CC	MS-DRG	620	7	—	—	$7,529.42	$12,461	0.77×	$60,154
OR procedure for obesity w/o CC/MCC	MS-DRG	621	7	—	—	$7,529.42	$11,745	0.77×	$48,566
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	7	—	—	$7,529.42	$9,660.92	0.79×	$41,123
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	7	—	—	$7,529.42	$15,956	0.83×	$48,001
PCI single major coronary artery	CPT	92920	14	$28,986	$17,392	$773.91	$7,333.66	1.3×	$26,957
PCI with drug-eluting stent	CPT	92928	14	$44,026	$26,416	$859.73	$13,002	1.3×	$40,944
Left heart catheterization	CPT	93452	14	$23,070	$13,842	$1,056.32	$4,969.8	1.6×	$21,455
Coronary angiography with cath	CPT	93455	14	$17,248	$10,349	$1,289.74	$5,759.92	1.8×	$16,041
Coronary angiography with bypass cath	CPT	93458	14	$31,252	$18,751	$1,321.51	$7,236.31	2.3×	$29,064

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

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

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