Apl(pml-rara) quant - sendout at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,189.80
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.
?
What you pay up front if you don't use insurance.
$1,983.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$204.89 with UPMC Work Partners vs $1,796.06 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $204.89 | ↓ -83% |
| UPMC Health Plan | Managed Medicare | $207.87 | ↓ -83% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $211.79 | ↓ -82% |
| Aetna of PA | Medicare | $217.68 | ↓ -82% |
| United Healthcare | Unison Advantage Non Special Needs | $217.68 | ↓ -82% |
| United Healthcare | Medicare | $221.82 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicare | $223.87 | ↓ -81% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $223.89 | ↓ -81% |
| Cigna | Medicare | $223.89 | ↓ -81% |
| AmeriHealth Caritas | Medicare | $223.89 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $226.26 | ↓ -81% |
| United Healthcare | Unison Advantage Special Needs | $228.04 | ↓ -81% |
| Aetna | Medicare | $228.04 | ↓ -81% |
| UPMC Health Plan | Commercial | $230.47 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $248.89 | ↓ -79% |
| United Healthcare Community Plan for Families | Unison Kids | $260.20 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $314.48 | ↓ -74% |
| Highmark Wholecare (prev Gateway) | Medicaid | $335.54 | ↓ -72% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $353.21 | ↓ -70% |
| PA Health & Wellness | PA Medicaid HMO | $385.59 | ↓ -68% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $385.73 | ↓ -68% |
| United Healthcare | Compass Exchange | $654.39 | ↓ -45% |
| Highmark BCBS of PA | Managed Care - Social Mission | $670.54 | ↓ -44% |
| Aetna | Neighborhood Network | $696.03 | ↓ -42% |
| Aetna | EBR FI | $753.54 | ↓ -37% |
| Aetna | Home Depot Employer Group | $757.51 | ↓ -36% |
| Cigna | NBR ASO/FI | $773.37 | ↓ -35% |
| Aetna | NBR ASO/FI | $773.37 | ↓ -35% |
| United Healthcare | All Business | $773.37 | ↓ -35% |
| Cigna | New Business ASO | $773.37 | ↓ -35% |
| Aetna | EBR ASO | $793.20 | ↓ -33% |
| Cigna | Commercial | $793.20 | ↓ -33% |
| Cigna | EBR | $793.20 | ↓ -33% |
| UPMC Health Plan | CHIP | $837.82 | ↓ -30% |
| Highmark BCBS of PA | Managed Care | $898.03 | ↓ -25% |
| InterGroup | PPO | $991.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,116.44 | ↓ -6% |
| Coventry/First Health | Commercial | $1,388.10 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,495.22 | ↑ +26% |
| Private Health Care Systems | PPO | $1,586.40 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $1,796.06 | ↑ +51% |
Visitor-reported prices
Comments
Apl(pml-rara) quant - sendout at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $415.80 | $204.89 – $554.40 |
| UPMC Northwest | Seneca | $2,235.60 | $188.01 – $260.20 |
| UPMC Horizon-Greenville | Greenville | $1,446.00 | $185.60 – $389.02 |
| UPMC Jameson | New Castle | $790.80 | $204.89 – $388.84 |
| UPMC Magee | Pittsburgh | $1,396.80 | $194.02 – $385.73 |
| UPMC Passavant-McCandless | Pittsburgh | $1,812.60 | $192.65 – $385.73 |
| UPMC Presbyterian | Pittsburgh | $765.00 | $204.89 – $385.73 |
| UPMC Wellsboro | Wellsboro | $503.20 | $204.89 – $385.59 |