Cap trach decann 15mm at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,444.80
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.
$2,408.00
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.
$136.04 with Health Partners Plans (Jefferson Health Plan) vs $4,457.71 with UPMC Health Plan — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $136.04 | ↓ -91% |
| Aetna | Medicare | $150.25 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $157.52 | ↓ -89% |
| United Healthcare | Compass Exchange | $198.33 | ↓ -86% |
| Aetna | Neighborhood Network | $210.95 | ↓ -85% |
| Aetna | EBR FI | $228.38 | ↓ -84% |
| Aetna | Home Depot Employer Group | $229.58 | ↓ -84% |
| Aetna | NBR ASO/FI | $234.39 | ↓ -84% |
| Cigna | New Business ASO | $234.39 | ↓ -84% |
| Cigna | NBR ASO/FI | $234.39 | ↓ -84% |
| United Healthcare | All Business | $234.39 | ↓ -84% |
| PA Health & Wellness | PA Medicaid HMO | $236.28 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $236.28 | ↓ -84% |
| Cigna | Commercial | $240.40 | ↓ -83% |
| Cigna | EBR | $240.40 | ↓ -83% |
| Aetna | EBR ASO | $240.40 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $242.22 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $300.50 | ↓ -79% |
| InterGroup | PPO | $300.50 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $339.53 | ↓ -76% |
| Coventry/First Health | Commercial | $420.70 | ↓ -71% |
| Private Health Care Systems | PPO | $480.80 | ↓ -67% |
| Highmark BCBS of PA | Managed Care - Social Mission | $977.71 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $982.72 | ↓ -32% |
| Highmark BCBS of PA | Managed Care | $1,309.35 | ↓ -9% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,316.14 | ↓ -9% |
| Highmark BCBS of PA | UPMC Emergent | $2,618.71 | ↑ +81% |
| UPMC Health Plan | CHIP | $3,673.43 | ↑ +154% |
| UPMC Health Plan | Commercial | $4,457.71 | ↑ +209% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Cap trach decann 15mm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,029.00 | $91.58 – $3,673.43 |
| UPMC Bedford | Everett | $405.00 | $128.25 – $3,673.43 |
| UPMC Community Osteopathic | Harrisburg | $1,737.00 | $51.80 – $3,673.43 |
| UPMC Hamot | Erie | $3,402.00 | $336.33 – $336.33 |
| UPMC Northwest | Seneca | $1,444.80 | $872.91 – $4,445.18 |
| UPMC Horizon-Greenville | Greenville | $1,444.80 | $857.17 – $3,673.43 |
| UPMC Jameson | New Castle | $1,444.80 | $342.27 – $3,673.43 |
| UPMC Magee | Pittsburgh | $2,232.00 | $339.53 – $3,673.43 |