Cystouretero w/stone remove at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$6,187.80
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.
$10,313.00
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.
$824.16 with UPMC Work Partners vs $8,250.40 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 Work Partners | Workers Comp | $824.16 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,119.58 | ↓ -82% |
| UPMC Health Plan | CHIP | $1,375.58 | ↓ -78% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,492.78 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,240.42 | ↓ -48% |
| UPMC Health Plan | Managed Medicare | $3,297.06 | ↓ -47% |
| Highmark BCBS of PA | Managed Care | $3,338.44 | ↓ -46% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,359.20 | ↓ -46% |
| United Healthcare | Compass Exchange | $3,403.29 | ↓ -45% |
| Aetna of PA | Medicare | $3,452.59 | ↓ -44% |
| United Healthcare | Unison Advantage Non Special Needs | $3,452.59 | ↓ -44% |
| United Healthcare | Medicare | $3,518.35 | ↓ -43% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,550.91 | ↓ -43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,551.23 | ↓ -43% |
| Cigna | Medicare | $3,551.23 | ↓ -43% |
| AmeriHealth Caritas | Medicare | $3,551.23 | ↓ -43% |
| United Healthcare | Unison Advantage Special Needs | $3,617.00 | ↓ -42% |
| Aetna | Medicare | $3,617.00 | ↓ -42% |
| Aetna | Neighborhood Network | $3,619.86 | ↓ -42% |
| Aetna | EBR FI | $3,918.94 | ↓ -37% |
| Aetna | Home Depot Employer Group | $3,939.57 | ↓ -36% |
| Cigna | NBR ASO/FI | $4,022.07 | ↓ -35% |
| United Healthcare | All Business | $4,022.07 | ↓ -35% |
| Aetna | NBR ASO/FI | $4,022.07 | ↓ -35% |
| Cigna | New Business ASO | $4,022.07 | ↓ -35% |
| Cigna | EBR | $4,125.20 | ↓ -33% |
| Aetna | EBR ASO | $4,125.20 | ↓ -33% |
| Cigna | Commercial | $4,125.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,339.83 | ↓ -30% |
| UPMC Health Plan | Commercial | $5,058.53 | ↓ -18% |
| InterGroup | PPO | $5,156.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $5,672.15 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $5,672.15 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $6,676.89 | ↑ +8% |
| Coventry/First Health | Commercial | $7,219.10 | ↑ +17% |
| Private Health Care Systems | PPO | $8,250.40 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Cystouretero w/stone remove at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $7,240.20 | $824.16 – $9,653.60 |
| UPMC Cole | Coudersport | $514.80 | $237.84 – $1,470.59 |
| Uniontown Hospital | Uniontown | $2,468.33 | $205.80 – $7,096.32 |
| UPMC Bedford | Everett | not published | $758.71 – $3,551.23 |
| UPMC Carlisle | Carlisle | not published | $862.50 – $5,278.96 |
| UPMC Community Osteopathic | Harrisburg | not published | $862.50 – $7,348.95 |
| UPMC Hamot | Erie | not published | $824.16 – $4,782.42 |
| UPMC Northwest | Seneca | not published | $649.82 – $3,551.23 |