App high cost ss t/a/l >100sq cm addl 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.
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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.
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The hospital's undiscounted list price — almost no one pays this.
$98.45 with UPMC Work Partners vs $3,518.34 with Highmark BCBS of PA — 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 | $98.45 | — |
| UPMC Health Plan | Commercial | $167.95 | — |
| UPMC Health Plan | CHIP | $294.00 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $589.95 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,313.55 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,707.51 | — |
| Highmark BCBS of PA | Managed Care | $1,759.17 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $2,286.84 | — |
| Highmark BCBS of PA | UPMC Emergent | $3,518.34 | — |
Visitor-reported prices
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App high cost ss t/a/l >100sq cm addl 100sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,772.40 | $45.56 – $2,510.90 |
| UPMC Hamot | Erie | $1,200.00 | $98.45 – $584.39 |
| UPMC Hanover | Hanover | $1,772.40 | $45.56 – $294.00 |
| UPMC Horizon-Greenville | Greenville | $2,889.00 | $98.45 – $1,136.90 |
| UPMC Jameson | New Castle | $2,569.80 | $39.52 – $594.70 |
| UPMC Lititz | Lititz | $1,772.40 | $39.52 – $294.00 |
| UPMC McKeesport | Mckeesport | $2,927.40 | $43.47 – $589.95 |
| UPMC St. Margaret | Pittsburgh | $3,272.40 | $98.45 – $589.95 |