Bx perianal mass at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$106.20
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.
$177.00
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.
$18.77 with Highmark BCBS of PA vs $956.13 with Aetna — 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 | ↓ -82% |
| UPMC Health Plan | Commercial | $28.47 | ↓ -73% |
| Highmark BCBS of PA | Managed Care - Social Mission | $41.78 | ↓ -61% |
| UPMC Health Plan | CHIP | $49.84 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $54.31 | ↓ -49% |
| Highmark BCBS of PA | Managed Care | $55.95 | ↓ -47% |
| United Healthcare | Compass Exchange | $58.41 | ↓ -45% |
| Aetna | Neighborhood Network | $62.13 | ↓ -41% |
| Aetna | EBR FI | $67.26 | ↓ -37% |
| Aetna | Home Depot Employer Group | $67.61 | ↓ -36% |
| Cigna | NBR ASO/FI | $69.03 | ↓ -35% |
| United Healthcare | All Business | $69.03 | ↓ -35% |
| Aetna | NBR ASO/FI | $69.03 | ↓ -35% |
| Cigna | New Business ASO | $69.03 | ↓ -35% |
| Aetna | EBR ASO | $70.80 | ↓ -33% |
| Cigna | Commercial | $70.80 | ↓ -33% |
| Cigna | EBR | $70.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $72.74 | ↓ -32% |
| InterGroup | PPO | $88.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $97.35 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $97.35 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $111.91 | ↑ +5% |
| Coventry/First Health | Commercial | $123.90 | ↑ +17% |
| Private Health Care Systems | PPO | $141.60 | ↑ +33% |
| UPMC Health Plan | Managed Medicare | $871.56 | ↑ +721% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $887.98 | ↑ +736% |
| Aetna of PA | Medicare | $912.67 | ↑ +759% |
| United Healthcare | Unison Advantage Non Special Needs | $912.67 | ↑ +759% |
| United Healthcare | Medicare | $930.05 | ↑ +776% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↑ +784% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↑ +784% |
| Cigna | Medicare | $938.75 | ↑ +784% |
| AmeriHealth Caritas | Medicare | $938.75 | ↑ +784% |
| United Healthcare | Unison Advantage Special Needs | $956.13 | ↑ +800% |
| Aetna | Medicare | $956.13 | ↑ +800% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bx perianal mass at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $120.00 | $18.59 – $938.75 |
| UPMC Carlisle | Carlisle | $2,348.40 | $49.84 – $3,326.90 |
| UPMC Community Osteopathic | Harrisburg | $2,348.40 | $49.84 – $3,326.90 |
| UPMC Hamot | Erie | $117.00 | $18.59 – $1,264.19 |
| UPMC Hanover | Hanover | $2,348.40 | $49.84 – $1,393.54 |
| UPMC Horizon-Greenville | Greenville | $666.60 | $27.92 – $938.75 |
| UPMC Lititz | Lititz | $2,348.40 | $49.84 – $1,401.06 |
| UPMC Memorial | York | $2,348.40 | $15.15 – $1,398.78 |