healthcosts.net
Colonoscopy (with polyp removal) at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,055.20
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.
?
What you pay up front if you don't use insurance.
$5,092.00
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.
$294.89 with UPMC Health Plan vs $4,393.81 with Highmark BCBS of PA — 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 Medicaid | $294.89 | ↓ -90% |
| United Healthcare Community Plan for Families | Unison Kids | $308.29 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $372.60 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $397.56 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $404.26 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $418.50 | ↓ -86% |
| PA Health & Wellness | PA Medicaid HMO | $456.86 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -76% |
| UPMC Health Plan | Managed Medicare | $1,127.15 | ↓ -63% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,148.39 | ↓ -62% |
| United Healthcare | Unison Advantage Non Special Needs | $1,180.32 | ↓ -61% |
| Aetna of PA | Medicare | $1,180.32 | ↓ -61% |
| United Healthcare | Medicare | $1,202.80 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,213.93 | ↓ -60% |
| AmeriHealth Caritas | Medicare | $1,214.04 | ↓ -60% |
| Cigna | Medicare | $1,214.04 | ↓ -60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,214.04 | ↓ -60% |
| Aetna | Medicare | $1,236.52 | ↓ -60% |
| United Healthcare | Unison Advantage Special Needs | $1,236.52 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $1,240.30 | ↓ -59% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,640.41 | ↓ -46% |
| United Healthcare | Compass Exchange | $1,680.36 | ↓ -45% |
| Aetna | Neighborhood Network | $1,787.29 | ↓ -42% |
| Aetna | EBR FI | $1,934.96 | ↓ -37% |
| Aetna | Home Depot Employer Group | $1,945.14 | ↓ -36% |
| Cigna | NBR ASO/FI | $1,985.88 | ↓ -35% |
| Aetna | NBR ASO/FI | $1,985.88 | ↓ -35% |
| Cigna | New Business ASO | $1,985.88 | ↓ -35% |
| United Healthcare | All Business | $1,985.88 | ↓ -35% |
| Cigna | EBR | $2,036.80 | ↓ -33% |
| Cigna | Commercial | $2,036.80 | ↓ -33% |
| Aetna | EBR ASO | $2,036.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,132.40 | ↓ -30% |
| Highmark BCBS of PA | Managed Care | $2,196.91 | ↓ -28% |
| UPMC Health Plan | CHIP | $2,297.51 | ↓ -25% |
| UPMC Health Plan | Commercial | $2,497.63 | ↓ -18% |
| InterGroup | PPO | $2,546.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,855.88 | ↓ -7% |
| Coventry/First Health | Commercial | $3,564.40 | ↑ +17% |
| Private Health Care Systems | PPO | $4,073.60 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $4,393.81 | ↑ +44% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy (with polyp removal) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,705.20 | $294.89 – $6,665.70 |
| UPMC Hamot | Erie | $3,098.40 | $294.89 – $3,614.80 |
| UPMC Altoona | Altoona | $1,764.60 | $268.08 – $2,352.80 |
| UPMC Bedford | Everett | $1,581.00 | $281.48 – $2,371.50 |
| UPMC Cole | Coudersport | $862.80 | $281.48 – $1,152.55 |
| UPMC Community Osteopathic | Harrisburg | $1,666.80 | $330.00 – $2,297.51 |
| UPMC Horizon-Greenville | Greenville | $2,476.20 | $294.89 – $3,507.95 |
| UPMC Jameson | New Castle | $2,476.20 | $294.89 – $3,631.76 |