Bx pancreas pq ndl at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,529.80
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.
$5,883.00
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.
$550.23 with Highmark BCBS of PA vs $4,706.40 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $550.23 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $639.06 | ↓ -82% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,225.10 | ↓ -65% |
| UPMC Health Plan | Managed Medicare | $1,548.87 | ↓ -56% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,578.07 | ↓ -55% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,592.54 | ↓ -55% |
| United Healthcare | Unison Advantage Non Special Needs | $1,621.93 | ↓ -54% |
| Aetna of PA | Medicare | $1,621.93 | ↓ -54% |
| Highmark BCBS of PA | Managed Care | $1,640.71 | ↓ -54% |
| United Healthcare | Medicare | $1,652.83 | ↓ -53% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,668.12 | ↓ -53% |
| AmeriHealth Caritas | Medicare | $1,668.28 | ↓ -53% |
| Cigna | Medicare | $1,668.28 | ↓ -53% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,668.28 | ↓ -53% |
| Aetna | Medicare | $1,699.17 | ↓ -52% |
| United Healthcare | Unison Advantage Special Needs | $1,699.17 | ↓ -52% |
| UPMC Health Plan | CHIP | $1,731.02 | ↓ -51% |
| United Healthcare | Compass Exchange | $1,941.39 | ↓ -45% |
| Aetna | Neighborhood Network | $2,064.93 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,132.85 | ↓ -40% |
| Aetna | EBR FI | $2,235.54 | ↓ -37% |
| Aetna | Home Depot Employer Group | $2,247.31 | ↓ -36% |
| Cigna | NBR ASO/FI | $2,294.37 | ↓ -35% |
| United Healthcare | All Business | $2,294.37 | ↓ -35% |
| Aetna | NBR ASO/FI | $2,294.37 | ↓ -35% |
| Cigna | New Business ASO | $2,294.37 | ↓ -35% |
| Aetna | EBR ASO | $2,353.20 | ↓ -33% |
| Cigna | Commercial | $2,353.20 | ↓ -33% |
| Cigna | EBR | $2,353.20 | ↓ -33% |
| UPMC Health Plan | Commercial | $2,885.61 | ↓ -18% |
| InterGroup | PPO | $2,941.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $3,235.65 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $3,235.65 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $3,281.43 | ↓ -7% |
| Coventry/First Health | Commercial | $4,118.10 | ↑ +17% |
| Private Health Care Systems | PPO | $4,706.40 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bx pancreas pq ndl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,080.80 | $475.12 – $2,947.80 |
| UPMC Community Osteopathic | Harrisburg | $2,080.80 | $660.67 – $2,947.80 |
| UPMC Northwest | Seneca | $3,197.40 | $631.31 – $1,668.28 |
| UPMC Hanover | Hanover | $2,080.80 | $660.67 – $2,476.51 |
| UPMC Lititz | Lititz | $2,080.80 | $628.82 – $2,489.89 |
| UPMC Memorial | York | $2,080.80 | $444.23 – $2,485.84 |
| UPMC Mercy | Pittsburgh | $2,236.20 | $444.00 – $1,699.17 |
| UPMC Muncy | Muncy | $971.40 | $639.06 – $993.28 |