CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: UPMC Passavant

Billing Code: 99203 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 99203
  • Insurance Median: $169
  • Cash Discount Price: $239
  • vs. Medicare Baseline: 1.44x Medicare
The contracted insurance negotiated median rate for a New patient office visit (30-44 min) at UPMC Passavant is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $117.57, this hospital’s rate is 1.44x the Medicare baseline. Located in 9100 Babcock Boulevard, Pittsburgh, PA.
Cash / Self-Pay
$239

Average discount available for prompt cash payment at this facility.

Insurance Median
$169

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$117.57

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $117.57 (100%)
Cash / Self-Pay: $239 (203%)
Insurance Median: $169 (144%)
Cash: $239 (203% of Medicare)
Ins. Median: $169 (144% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $117.57 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $36 - $100 31%
Upmc Health Plan $60 51%
UnitedHealthcare $62 53%
Cigna $64 - $159 54%
Highmark Wholecare (Prev Gateway) $80 - $199 68%
Amerihealth Caritas $85 72%
Pa Health & Wellness $92 78%
Blue Cross Blue Shield $97 - $449 83%
Upmc Work Partners $139 118%
Private Health Care Systems $162 - $370 138%
Health Plan Of Upper Ohio Valley $184 157%
Coventry/First Health $279 237%
Intergroup $330 - $358 281%
Humana $338 - $370 287%
Multiplan $338 - $370 287%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 9100 Babcock Boulevard, Pittsburgh, PA 15237
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals