Running a hospital or health system isn't the only way to make a buck in the world of nonprofit health care.

Highmark Inc., the region's dominant health insurer, is a nonprofit company that paid Chief Executive Officer Kenneth R. Melani $1.67 million in salary, bonus and other compensation in 2004.

Compensation for Melani and the nine other executives who round out the Top 10 earners at Highmark topped $8 million, according to the insurer's annual filing with the Pennsylvania Department of Insurance. The company paid a total of $838,154.95 to the 23 members on its board of directors.

Central Blood Bank paid CEO William H. Portman $463,600 in compensation in fiscal 2004 plus $65,699 in benefits, putting his total package at $529,299.

But six-figure salaries are nothing new in the nonprofit world. A report this month from the New Jersey group Charity Navigator found that the average compensation of CEOs at 4,257 charities tracked by the group was $148,477.

Many health-care chiefs in Allegheny County make more than the Charity Navigator average, but its survey largely excludes hospitals, insurance companies and blood banks, said Sandra Miniutti, a Charity Navigator spokeswoman. Charity Navigator is meant primarily as a buyer's guide for nonprofits that solicit funds from donors, she said, noting that health-care nonprofits generate most of their revenue from patient care services, not fundraising.

"The average charity's CEO's salary makes up about 3.4 percent of the organization's total functional expenses," Charity Navigator noted. "This isn't outrageous when you consider that these are multimillion-dollar operations. ... Attracting and retaining that type of talent requires a certain level of compensation -- roughly $150,000, according to our analysis."

Central Blood Bank reported revenue of $43.5 million for 2004, meaning Portman's salary doesn't raise a red flag, according to Charity Navigator.

That's even more the case at Highmark, where Melani's $1.67 million is dwarfed by the company's revenue of nearly $9 billion last year. A similar argument could be made for the University of Pittsburgh Medical Center's Jeffrey Romoff, who received $2.4 million while UPMC revenue approached $5 billion.