Bx breast pq tomo guide 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.
$18.77 with Highmark BCBS of PA vs $4,015.84 with United Healthcare — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | — |
| UPMC Health Plan | Commercial | $26.97 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $41.78 | — |
| UPMC Health Plan | CHIP | $47.21 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $54.31 | — |
| Highmark BCBS of PA | Managed Care | $55.95 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $72.74 | — |
| Highmark BCBS of PA | UPMC Emergent | $111.91 | — |
| UPMC Health Plan | Managed Medicare | $3,660.62 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,729.62 | — |
| United Healthcare | Unison Advantage Non Special Needs | $3,833.30 | — |
| Aetna of PA | Medicare | $3,833.30 | — |
| United Healthcare | Medicare | $3,906.31 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $3,942.46 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,942.82 | — |
| Cigna | Medicare | $3,942.82 | — |
| AmeriHealth Caritas | Medicare | $3,942.82 | — |
| Aetna | Medicare | $4,015.84 | — |
| United Healthcare | Unison Advantage Special Needs | $4,015.84 | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Bx breast pq tomo guide at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $7,249.80 | $47.21 – $10,270.55 |
| UPMC Community Osteopathic | Harrisburg | $7,249.80 | $47.21 – $10,270.55 |
| UPMC Hanover | Hanover | $7,249.80 | $47.21 – $5,852.98 |
| UPMC Lititz | Lititz | $7,249.80 | $47.21 – $5,884.59 |
| UPMC Memorial | York | $7,249.80 | $15.15 – $5,875.04 |
| UPMC Somerset | Somerset | $7,249.80 | $18.40 – $3,942.46 |
| WellSpan Ephrata Community Hospital | Ephrata | $2,424.80 | $2,871.96 – $2,871.96 |
| WellSpan Evangelical Community Hospital | Lewisburg | $9,758.40 | $86.34 – $86.34 |