Conversion ext bil drg cath at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,058.80
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.
$5,098.00
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.
$209.58 with UPMC Health Plan vs $4,452.90 with Highmark BCBS of PA — 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 | $209.58 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison Kids | $219.11 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $264.82 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $282.56 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $287.32 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $297.44 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $324.70 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $746.66 | ↓ -76% |
| UPMC Work Partners | Workers Comp | $1,416.56 | ↓ -54% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,662.47 | ↓ -46% |
| United Healthcare | Compass Exchange | $1,682.34 | ↓ -45% |
| UPMC Health Plan | CHIP | $1,784.30 | ↓ -42% |
| Aetna | Neighborhood Network | $1,789.40 | ↓ -41% |
| Aetna | EBR FI | $1,937.24 | ↓ -37% |
| Aetna | Home Depot Employer Group | $1,947.44 | ↓ -36% |
| United Healthcare | All Business | $1,988.22 | ↓ -35% |
| Aetna | NBR ASO/FI | $1,988.22 | ↓ -35% |
| Cigna | New Business ASO | $1,988.22 | ↓ -35% |
| Cigna | NBR ASO/FI | $1,988.22 | ↓ -35% |
| Cigna | EBR | $2,039.20 | ↓ -33% |
| Cigna | Commercial | $2,039.20 | ↓ -33% |
| Aetna | EBR ASO | $2,039.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,161.07 | ↓ -29% |
| Highmark BCBS of PA | Managed Care | $2,226.45 | ↓ -27% |
| UPMC Health Plan | Commercial | $2,500.57 | ↓ -18% |
| InterGroup | PPO | $2,549.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,894.28 | ↓ -5% |
| UPMC Health Plan | Managed Medicare | $3,373.62 | ↑ +10% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,437.21 | ↑ +12% |
| Aetna of PA | Medicare | $3,532.77 | ↑ +15% |
| United Healthcare | Unison Advantage Non Special Needs | $3,532.77 | ↑ +15% |
| Coventry/First Health | Commercial | $3,568.60 | ↑ +17% |
| United Healthcare | Medicare | $3,600.06 | ↑ +18% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,633.37 | ↑ +19% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,633.70 | ↑ +19% |
| AmeriHealth Caritas | Medicare | $3,633.70 | ↑ +19% |
| Cigna | Medicare | $3,633.70 | ↑ +19% |
| Aetna | Medicare | $3,700.99 | ↑ +21% |
| United Healthcare | Unison Advantage Special Needs | $3,700.99 | ↑ +21% |
| Private Health Care Systems | PPO | $4,078.40 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $4,452.90 | ↑ +46% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Conversion ext bil drg cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,273.40 | $190.53 – $3,031.20 |
| UPMC Carlisle | Carlisle | $7,502.40 | $241.97 – $10,628.40 |
| UPMC Community Osteopathic | Harrisburg | $7,502.40 | $257.22 – $10,628.40 |
| UPMC Hamot | Erie | $4,060.80 | $209.58 – $4,893.48 |
| UPMC Hanover | Hanover | $7,502.40 | $241.97 – $5,394.10 |
| UPMC Lititz | Lititz | $7,502.40 | $241.97 – $5,423.23 |
| UPMC Memorial | York | $7,502.40 | $241.97 – $5,414.43 |
| UPMC Passavant-McCandless | Pittsburgh | $8,884.20 | $209.58 – $3,700.99 |