5' nucleotidase - sendout at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$166.20
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.
$277.00
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.
$11.02 with UPMC Work Partners vs $221.60 with Private Health Care Systems — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $11.02 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $11.18 | ↓ -93% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11.39 | ↓ -93% |
| Aetna of PA | Medicare | $11.71 | ↓ -93% |
| United Healthcare | Unison Advantage Non Special Needs | $11.71 | ↓ -93% |
| United Healthcare | Medicare | $11.93 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12.04 | ↓ -93% |
| Cigna | Medicare | $12.04 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.04 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $12.04 | ↓ -93% |
| Aetna | Medicare | $12.27 | ↓ -93% |
| United Healthcare | Unison Advantage Special Needs | $12.27 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $15.41 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $16.95 | ↓ -90% |
| United Healthcare Community Plan for Families | Unison Kids | $17.72 | ↓ -89% |
| UPMC Health Plan | Commercial | $19.47 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $21.42 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $21.77 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $22.85 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $24.06 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $26.26 | ↓ -84% |
| Highmark BCBS of PA | Managed Care - Social Mission | $37.84 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $50.68 | ↓ -70% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $63.00 | ↓ -62% |
| UPMC Health Plan | CHIP | $70.78 | ↓ -57% |
| Highmark BCBS of PA | Commercial - Indemnity | $84.38 | ↓ -49% |
| United Healthcare | Compass Exchange | $91.41 | ↓ -45% |
| Aetna | Neighborhood Network | $97.23 | ↓ -41% |
| Highmark BCBS of PA | UPMC Emergent | $101.35 | ↓ -39% |
| Aetna | EBR FI | $105.26 | ↓ -37% |
| Aetna | Home Depot Employer Group | $105.81 | ↓ -36% |
| Cigna | NBR ASO/FI | $108.03 | ↓ -35% |
| Aetna | NBR ASO/FI | $108.03 | ↓ -35% |
| United Healthcare | All Business | $108.03 | ↓ -35% |
| Cigna | New Business ASO | $108.03 | ↓ -35% |
| Cigna | EBR | $110.80 | ↓ -33% |
| Cigna | Commercial | $110.80 | ↓ -33% |
| Aetna | EBR ASO | $110.80 | ↓ -33% |
| InterGroup | PPO | $138.50 | ↓ -17% |
| Coventry/First Health | Commercial | $193.90 | ↑ +17% |
| Private Health Care Systems | PPO | $221.60 | ↑ +33% |
Visitor-reported prices
Comments
5' nucleotidase - sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $136.80 | $11.02 – $182.40 |
| UPMC Bedford | Everett | $123.00 | $4.02 – $184.50 |
| UPMC Carlisle | Carlisle | $56.40 | $11.04 – $79.90 |
| UPMC Community Osteopathic | Harrisburg | $56.40 | $11.04 – $79.90 |
| UPMC Hamot | Erie | $119.40 | $11.02 – $21.56 |
| UPMC Northwest | Seneca | $58.80 | $10.11 – $17.72 |
| UPMC Hanover | Hanover | $56.40 | $11.04 – $20.99 |
| UPMC Horizon-Greenville | Greenville | $64.80 | $9.98 – $21.42 |