Bilateral n block inj occipital 64405 at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,902.00
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.
$3,170.00
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.
$38.50 with UPMC Health Plan vs $2,536.00 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 | Managed Medicaid | $38.50 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison Kids | $40.25 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $48.65 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $51.91 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $52.78 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $54.64 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $59.65 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $158.27 | ↓ -92% |
| UPMC Health Plan | Managed Medicare | $282.19 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $287.51 | ↓ -85% |
| United Healthcare | Unison Advantage Non Special Needs | $295.50 | ↓ -84% |
| Aetna of PA | Medicare | $295.50 | ↓ -84% |
| United Healthcare | Medicare | $301.13 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $303.92 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $303.94 | ↓ -84% |
| Cigna | Medicare | $303.94 | ↓ -84% |
| AmeriHealth Caritas | Medicare | $303.94 | ↓ -84% |
| United Healthcare | Unison Advantage Special Needs | $309.57 | ↓ -84% |
| Aetna | Medicare | $309.57 | ↓ -84% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $337.77 | ↓ -82% |
| Highmark BCBS of PA | Managed Care - Social Mission | $752.06 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $977.62 | ↓ -49% |
| Highmark BCBS of PA | Managed Care | $1,007.19 | ↓ -47% |
| United Healthcare | Compass Exchange | $1,046.10 | ↓ -45% |
| UPMC Health Plan | CHIP | $1,047.14 | ↓ -45% |
| Aetna | Neighborhood Network | $1,112.67 | ↓ -42% |
| Aetna | EBR FI | $1,204.60 | ↓ -37% |
| Aetna | Home Depot Employer Group | $1,210.94 | ↓ -36% |
| Aetna | NBR ASO/FI | $1,236.30 | ↓ -35% |
| Cigna | NBR ASO/FI | $1,236.30 | ↓ -35% |
| Cigna | New Business ASO | $1,236.30 | ↓ -35% |
| United Healthcare | All Business | $1,236.30 | ↓ -35% |
| Cigna | Commercial | $1,268.00 | ↓ -33% |
| Aetna | EBR ASO | $1,268.00 | ↓ -33% |
| Cigna | EBR | $1,268.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,309.30 | ↓ -31% |
| UPMC Health Plan | Commercial | $1,554.88 | ↓ -18% |
| InterGroup | PPO | $1,585.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $2,014.38 | ↑ +6% |
| Coventry/First Health | Commercial | $2,219.00 | ↑ +17% |
| Private Health Care Systems | PPO | $2,536.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bilateral n block inj occipital 64405 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,184.00 | $35.00 – $2,912.00 |
| UPMC Carlisle | Carlisle | $496.20 | $44.45 – $1,016.56 |
| UPMC Cole | Coudersport | $254.40 | $20.79 – $175.14 |
| UPMC Community Osteopathic | Harrisburg | $496.20 | $44.45 – $1,047.14 |
| UPMC Hamot | Erie | $1,959.60 | $38.50 – $409.31 |
| UPMC Northwest | Seneca | $1,959.60 | $38.50 – $295.50 |
| UPMC Hanover | Hanover | $496.20 | $44.45 – $1,016.56 |
| UPMC Horizon-Greenville | Greenville | $1,176.00 | $38.50 – $528.10 |