Colonoscopy w/injection at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,263.40
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.
$5,439.00
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.
$177.89 with Highmark BCBS of PA vs $4,351.20 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 | $177.89 | ↓ -95% |
| Highmark BCBS of PA | Managed Care - Social Mission | $396.08 | ↓ -88% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $514.88 | ↓ -84% |
| Highmark BCBS of PA | Managed Care | $530.45 | ↓ -84% |
| Highmark BCBS of PA | Commercial - Indemnity | $689.57 | ↓ -79% |
| Highmark BCBS of PA | UPMC Emergent | $1,060.91 | ↓ -67% |
| UPMC Health Plan | Managed Medicare | $1,127.15 | ↓ -65% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,148.39 | ↓ -65% |
| Aetna of PA | Medicare | $1,180.32 | ↓ -64% |
| United Healthcare | Unison Advantage Non Special Needs | $1,180.32 | ↓ -64% |
| United Healthcare | Medicare | $1,202.80 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,213.93 | ↓ -63% |
| AmeriHealth Caritas | Medicare | $1,214.04 | ↓ -63% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,214.04 | ↓ -63% |
| Cigna | Medicare | $1,214.04 | ↓ -63% |
| Aetna | Medicare | $1,236.52 | ↓ -62% |
| United Healthcare | Unison Advantage Special Needs | $1,236.52 | ↓ -62% |
| United Healthcare | Compass Exchange | $1,794.87 | ↓ -45% |
| UPMC Health Plan | CHIP | $1,903.65 | ↓ -42% |
| Aetna | Neighborhood Network | $1,909.09 | ↓ -41% |
| Aetna | EBR FI | $2,066.82 | ↓ -37% |
| Aetna | Home Depot Employer Group | $2,077.70 | ↓ -36% |
| Cigna | NBR ASO/FI | $2,121.21 | ↓ -35% |
| United Healthcare | All Business | $2,121.21 | ↓ -35% |
| Aetna | NBR ASO/FI | $2,121.21 | ↓ -35% |
| Cigna | New Business ASO | $2,121.21 | ↓ -35% |
| Aetna | EBR ASO | $2,175.60 | ↓ -33% |
| Cigna | Commercial | $2,175.60 | ↓ -33% |
| Cigna | EBR | $2,175.60 | ↓ -33% |
| UPMC Health Plan | Commercial | $2,667.83 | ↓ -18% |
| InterGroup | PPO | $2,719.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $2,991.45 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $2,991.45 | ↓ -8% |
| Coventry/First Health | Commercial | $3,807.30 | ↑ +17% |
| Private Health Care Systems | PPO | $4,351.20 | ↑ +33% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy w/injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,940.60 | $176.21 – $3,920.80 |
| UPMC Bedford | Everett | $2,448.60 | $405.58 – $3,672.90 |
| UPMC Hamot | Erie | $2,799.00 | $176.21 – $1,634.95 |
| UPMC Northwest | Seneca | $2,448.60 | $457.34 – $1,214.04 |
| UPMC Horizon-Greenville | Greenville | $2,310.60 | $342.82 – $1,214.04 |
| UPMC Jameson | New Castle | $2,449.20 | $179.32 – $1,517.55 |
| UPMC Magee | Pittsburgh | $2,448.60 | $177.89 – $1,236.52 |
| UPMC McKeesport | Mckeesport | $2,449.20 | $177.89 – $1,236.52 |