Biopsy needle lymph node superficial at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,519.80
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.
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What you pay up front if you don't use insurance.
$2,533.00
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.
$74.17 with UPMC Health Plan vs $3,281.43 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 Health Plan | Managed Medicaid | $74.17 | ↓ -95% |
| United Healthcare Community Plan for Families | Unison Kids | $77.54 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $93.72 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $100.00 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $101.68 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $105.26 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $114.91 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $360.10 | ↓ -76% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $550.23 | ↓ -64% |
| United Healthcare | Compass Exchange | $835.89 | ↓ -45% |
| Aetna | Neighborhood Network | $889.08 | ↓ -42% |
| Aetna | EBR FI | $962.54 | ↓ -37% |
| Aetna | Home Depot Employer Group | $967.61 | ↓ -36% |
| Aetna | NBR ASO/FI | $987.87 | ↓ -35% |
| United Healthcare | All Business | $987.87 | ↓ -35% |
| Cigna | New Business ASO | $987.87 | ↓ -35% |
| Cigna | NBR ASO/FI | $987.87 | ↓ -35% |
| Aetna | EBR ASO | $1,013.20 | ↓ -33% |
| Cigna | EBR | $1,013.20 | ↓ -33% |
| Cigna | Commercial | $1,013.20 | ↓ -33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,225.10 | ↓ -19% |
| UPMC Health Plan | Commercial | $1,242.44 | ↓ -18% |
| InterGroup | PPO | $1,266.50 | ↓ -17% |
| UPMC Health Plan | Managed Medicare | $1,548.87 | ↑ +2% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,578.07 | ↑ +4% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,592.54 | ↑ +5% |
| United Healthcare | Unison Advantage Non Special Needs | $1,621.93 | ↑ +7% |
| Aetna of PA | Medicare | $1,621.93 | ↑ +7% |
| Highmark BCBS of PA | Managed Care | $1,640.71 | ↑ +8% |
| United Healthcare | Medicare | $1,652.83 | ↑ +9% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.12 | ↑ +10% |
| AmeriHealth Caritas | Medicare | $1,668.28 | ↑ +10% |
| Cigna | Medicare | $1,668.28 | ↑ +10% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | ↑ +10% |
| United Healthcare | Unison Advantage Special Needs | $1,699.17 | ↑ +12% |
| Aetna | Medicare | $1,699.17 | ↑ +12% |
| UPMC Health Plan | CHIP | $1,714.66 | ↑ +13% |
| Coventry/First Health | Commercial | $1,773.10 | ↑ +17% |
| Private Health Care Systems | PPO | $2,026.40 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,132.85 | ↑ +40% |
| Highmark BCBS of PA | UPMC Emergent | $3,281.43 | ↑ +116% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy needle lymph node superficial at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,237.80 | $67.43 – $1,650.40 |
| UPMC Bedford | Everett | $3,913.20 | $70.80 – $5,869.80 |
| UPMC Carlisle | Carlisle | $2,461.20 | $85.64 – $3,486.70 |
| UPMC Cole | Coudersport | $144.60 | $66.81 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $2,461.20 | $91.03 – $3,486.70 |
| UPMC Hamot | Erie | $2,313.60 | $74.17 – $2,246.66 |
| UPMC Northwest | Seneca | $1,741.80 | $74.17 – $1,621.93 |
| UPMC Hanover | Hanover | $2,461.20 | $85.64 – $2,476.51 |