Clsd tx trimall ankle fx without manip 27816 at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$2,812.80
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.
?
What you pay up front if you don't use insurance.
$4,688.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$229.32 with UPMC Health Plan vs $3,750.40 with Private Health Care Systems — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 Medicare | $229.32 | ↓ -92% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $233.64 | ↓ -92% |
| Aetna of PA | Medicare | $240.13 | ↓ -91% |
| United Healthcare | Unison Advantage Non Special Needs | $240.13 | ↓ -91% |
| United Healthcare | Medicare | $244.71 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $246.97 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.00 | ↓ -91% |
| Cigna | Medicare | $247.00 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $247.00 | ↓ -91% |
| United Healthcare | Unison Advantage Special Needs | $251.57 | ↓ -91% |
| Aetna | Medicare | $251.57 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $550.23 | ↓ -80% |
| UPMC Work Partners | Workers Comp | $755.74 | ↓ -73% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,225.10 | ↓ -56% |
| United Healthcare | Compass Exchange | $1,547.04 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,592.54 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $1,640.71 | ↓ -42% |
| Aetna | Neighborhood Network | $1,645.49 | ↓ -41% |
| UPMC Health Plan | CHIP | $1,712.37 | ↓ -39% |
| Aetna | EBR FI | $1,781.44 | ↓ -37% |
| Aetna | Home Depot Employer Group | $1,790.82 | ↓ -36% |
| Cigna | NBR ASO/FI | $1,828.32 | ↓ -35% |
| United Healthcare | All Business | $1,828.32 | ↓ -35% |
| Aetna | NBR ASO/FI | $1,828.32 | ↓ -35% |
| Cigna | New Business ASO | $1,828.32 | ↓ -35% |
| Cigna | EBR | $1,875.20 | ↓ -33% |
| Aetna | EBR ASO | $1,875.20 | ↓ -33% |
| Cigna | Commercial | $1,875.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,132.85 | ↓ -24% |
| UPMC Health Plan | Commercial | $2,299.46 | ↓ -18% |
| InterGroup | PPO | $2,344.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $2,578.40 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $2,578.40 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $3,281.43 | ↑ +17% |
| Coventry/First Health | Commercial | $3,281.60 | ↑ +17% |
| Private Health Care Systems | PPO | $3,750.40 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx trimall ankle fx without manip 27816 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,505.20 | $233.23 – $4,673.60 |
| UPMC Bedford | Everett | $3,647.40 | $82.51 – $5,471.10 |
| UPMC Carlisle | Carlisle | $488.40 | $111.52 – $1,016.56 |
| UPMC Cole | Coudersport | $1,266.00 | $66.81 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $488.40 | $162.80 – $1,712.37 |
| UPMC Hamot | Erie | $2,223.60 | $263.94 – $755.74 |
| UPMC Hanover | Hanover | $488.40 | $226.87 – $1,712.37 |
| UPMC Jameson | New Castle | $379.80 | $228.70 – $892.40 |