App high cost ss t/a/l >100sq cm 1st 100sq cm at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
not published by hospital
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.
not published by hospital
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.
$420.87 with UPMC Work Partners vs $4,712.31 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 | $420.87 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $790.16 | — |
| UPMC Health Plan | CHIP | $1,031.18 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,759.31 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,286.97 | — |
| Highmark BCBS of PA | Managed Care | $2,356.15 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $3,062.89 | — |
| UPMC Health Plan | Managed Medicare | $3,499.72 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,565.69 | — |
| Aetna of PA | Medicare | $3,664.82 | — |
| United Healthcare | Unison Advantage Non Special Needs | $3,664.82 | — |
| United Healthcare | Medicare | $3,734.62 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $3,769.17 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,769.52 | — |
| AmeriHealth Caritas | Medicare | $3,769.52 | — |
| Cigna | Medicare | $3,769.52 | — |
| Aetna | Medicare | $3,839.33 | — |
| United Healthcare | Unison Advantage Special Needs | $3,839.33 | — |
| Highmark BCBS of PA | UPMC Emergent | $4,712.31 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
App high cost ss t/a/l >100sq cm 1st 100sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,513.80 | $440.44 – $6,394.55 |
| UPMC Hamot | Erie | $2,618.40 | $420.87 – $5,076.39 |
| UPMC Hanover | Hanover | $4,513.80 | $440.44 – $5,595.71 |
| UPMC Horizon-Greenville | Greenville | $3,868.20 | $420.87 – $3,769.52 |
| UPMC Jameson | New Castle | $3,441.60 | $420.87 – $4,711.90 |
| UPMC Lititz | Lititz | $4,513.80 | $440.44 – $5,625.95 |
| UPMC Magee | Pittsburgh | $3,461.40 | $420.87 – $3,839.33 |
| UPMC McKeesport | Mckeesport | $3,120.60 | $369.97 – $3,839.33 |