_afb org id by sequencing rflx ast-sendout at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,253.40
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.
$2,089.00
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.
$50.88 with UPMC Health Plan vs $1,671.20 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 Health Plan | Commercial | $50.88 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $114.02 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $115.67 | ↓ -91% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $117.85 | ↓ -91% |
| United Healthcare | Unison Advantage Non Special Needs | $121.13 | ↓ -90% |
| Aetna of PA | Medicare | $121.13 | ↓ -90% |
| United Healthcare | Medicare | $123.44 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $124.58 | ↓ -90% |
| AmeriHealth Caritas | Medicare | $124.59 | ↓ -90% |
| Cigna | Medicare | $124.59 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $124.59 | ↓ -90% |
| United Healthcare | Unison Advantage Special Needs | $126.90 | ↓ -90% |
| Aetna | Medicare | $126.90 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $132.18 | ↓ -89% |
| UPMC Health Plan | Managed Medicaid | $145.40 | ↓ -88% |
| United Healthcare Community Plan for Families | Unison Kids | $152.01 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $183.72 | ↓ -85% |
| UPMC Health Plan | CHIP | $184.97 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $196.02 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $206.35 | ↓ -84% |
| PA Health & Wellness | PA Medicaid HMO | $225.26 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $310.04 | ↓ -75% |
| Highmark BCBS of PA | Managed Care - Social Mission | $538.95 | ↓ -57% |
| United Healthcare | Compass Exchange | $689.37 | ↓ -45% |
| Highmark BCBS of PA | Managed Care | $721.80 | ↓ -42% |
| Aetna | Neighborhood Network | $733.24 | ↓ -41% |
| Aetna | EBR FI | $793.82 | ↓ -37% |
| Aetna | Home Depot Employer Group | $798.00 | ↓ -36% |
| Aetna | NBR ASO/FI | $814.71 | ↓ -35% |
| United Healthcare | All Business | $814.71 | ↓ -35% |
| Cigna | New Business ASO | $814.71 | ↓ -35% |
| Cigna | NBR ASO/FI | $814.71 | ↓ -35% |
| Cigna | Commercial | $835.60 | ↓ -33% |
| Aetna | EBR ASO | $835.60 | ↓ -33% |
| Cigna | EBR | $835.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $897.34 | ↓ -28% |
| InterGroup | PPO | $1,044.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,201.79 | ↓ -4% |
| Highmark BCBS of PA | UPMC Emergent | $1,443.59 | ↑ +15% |
| Coventry/First Health | Commercial | $1,462.30 | ↑ +17% |
| Private Health Care Systems | PPO | $1,671.20 | ↑ +33% |
Visitor-reported prices
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_afb org id by sequencing rflx ast-sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,507.80 | $114.02 – $2,010.40 |
| UPMC Bedford | Everett | $1,939.20 | $41.62 – $2,908.80 |
| UPMC Carlisle | Carlisle | $642.60 | $9.29 – $910.35 |
| UPMC Community Osteopathic | Harrisburg | $642.60 | $114.21 – $910.35 |
| UPMC Northwest | Seneca | $1,823.40 | $51.36 – $152.01 |
| UPMC Hanover | Hanover | $642.60 | $9.29 – $184.58 |
| UPMC Horizon-Greenville | Greenville | $1,105.80 | $51.52 – $216.47 |
| UPMC Jameson | New Castle | $1,105.80 | $114.01 – $312.53 |