Complx repair fccmnaxghf 13131 at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,824.40
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.
$6,374.00
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.
$78.10 with UPMC Health Plan vs $5,099.20 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $78.10 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison Kids | $81.65 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $98.68 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $105.29 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $107.07 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $110.84 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $121.00 | ↓ -97% |
| UPMC Health Plan | Managed Medicare | $381.93 | ↓ -90% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $389.13 | ↓ -90% |
| Aetna of PA | Medicare | $399.94 | ↓ -90% |
| United Healthcare | Unison Advantage Non Special Needs | $399.94 | ↓ -90% |
| United Healthcare | Medicare | $407.56 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicare | $411.33 | ↓ -89% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $411.37 | ↓ -89% |
| Cigna | Medicare | $411.37 | ↓ -89% |
| AmeriHealth Caritas | Medicare | $411.37 | ↓ -89% |
| United Healthcare | Unison Advantage Special Needs | $418.99 | ↓ -89% |
| Aetna | Medicare | $418.99 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $500.70 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -81% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,640.41 | ↓ -57% |
| United Healthcare | Compass Exchange | $2,103.42 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,132.40 | ↓ -44% |
| Highmark BCBS of PA | Managed Care | $2,196.91 | ↓ -43% |
| Aetna | Neighborhood Network | $2,237.27 | ↓ -42% |
| UPMC Health Plan | CHIP | $2,315.26 | ↓ -39% |
| Aetna | EBR FI | $2,422.12 | ↓ -37% |
| Aetna | Home Depot Employer Group | $2,434.87 | ↓ -36% |
| United Healthcare | All Business | $2,485.86 | ↓ -35% |
| Aetna | NBR ASO/FI | $2,485.86 | ↓ -35% |
| Cigna | NBR ASO/FI | $2,485.86 | ↓ -35% |
| Cigna | New Business ASO | $2,485.86 | ↓ -35% |
| Cigna | EBR | $2,549.60 | ↓ -33% |
| Cigna | Commercial | $2,549.60 | ↓ -33% |
| Aetna | EBR ASO | $2,549.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,855.88 | ↓ -25% |
| UPMC Health Plan | Commercial | $3,126.45 | ↓ -18% |
| InterGroup | PPO | $3,187.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $4,393.81 | ↑ +15% |
| Coventry/First Health | Commercial | $4,461.80 | ↑ +17% |
| Private Health Care Systems | PPO | $5,099.20 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Complx repair fccmnaxghf 13131 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,440.60 | $71.00 – $1,920.80 |
| UPMC Bedford | Everett | $4,893.00 | $74.55 – $7,339.50 |
| UPMC Carlisle | Carlisle | $911.40 | $90.17 – $1,291.15 |
| UPMC Cole | Coudersport | $1,693.20 | $74.55 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $911.40 | $90.17 – $2,315.26 |
| UPMC Hamot | Erie | $3,123.00 | $78.10 – $729.80 |
| UPMC Northwest | Seneca | $2,186.40 | $78.10 – $479.78 |
| UPMC Hanover | Hanover | $911.40 | $90.17 – $1,016.56 |