Dch validity tests at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$53.40
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.
$89.00
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.
$3.44 with UPMC Work Partners vs $71.20 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 Work Partners | Workers Comp | $3.44 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $3.49 | ↓ -93% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3.56 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $3.57 | ↓ -93% |
| United Healthcare | Unison Advantage Non Special Needs | $3.65 | ↓ -93% |
| Aetna of PA | Medicare | $3.65 | ↓ -93% |
| United Healthcare | Medicare | $3.72 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3.76 | ↓ -93% |
| Cigna | Medicare | $3.76 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $3.76 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $3.76 | ↓ -93% |
| Aetna | Medicare | $3.83 | ↓ -93% |
| United Healthcare | Unison Advantage Special Needs | $3.83 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $3.93 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison Kids | $4.11 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $4.96 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $5.29 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $5.57 | ↓ -90% |
| PA Health & Wellness | PA Medicaid HMO | $6.08 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $7.02 | ↓ -87% |
| UPMC Health Plan | Commercial | $7.22 | ↓ -86% |
| Highmark BCBS of PA | Managed Care - Social Mission | $12.20 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $16.34 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $20.31 | ↓ -62% |
| UPMC Health Plan | CHIP | $26.26 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Indemnity | $27.20 | ↓ -49% |
| United Healthcare | Compass Exchange | $29.37 | ↓ -45% |
| Aetna | Neighborhood Network | $31.24 | ↓ -41% |
| Highmark BCBS of PA | UPMC Emergent | $32.68 | ↓ -39% |
| Aetna | EBR FI | $33.82 | ↓ -37% |
| Aetna | Home Depot Employer Group | $34.00 | ↓ -36% |
| Cigna | NBR ASO/FI | $34.71 | ↓ -35% |
| Aetna | NBR ASO/FI | $34.71 | ↓ -35% |
| United Healthcare | All Business | $34.71 | ↓ -35% |
| Cigna | New Business ASO | $34.71 | ↓ -35% |
| Cigna | EBR | $35.60 | ↓ -33% |
| Cigna | Commercial | $35.60 | ↓ -33% |
| Aetna | EBR ASO | $35.60 | ↓ -33% |
| InterGroup | PPO | $44.50 | ↓ -17% |
| Coventry/First Health | Commercial | $62.30 | ↑ +17% |
| Private Health Care Systems | PPO | $71.20 | ↑ +33% |
Visitor-reported prices
Comments
Dch validity tests at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $18.60 | $3.44 – $24.80 |
| UPMC Bedford | Everett | $37.20 | $1.26 – $55.80 |
| UPMC Carlisle | Carlisle | $25.20 | $3.45 – $35.70 |
| UPMC Cole | Coudersport | $19.80 | $2.26 – $26.40 |
| UPMC Community Osteopathic | Harrisburg | $25.20 | $2.40 – $26.26 |
| UPMC Hamot | Erie | $19.80 | $3.44 – $6.95 |
| UPMC Northwest | Seneca | $18.60 | $3.16 – $4.11 |
| UPMC Hanover | Hanover | $25.20 | $3.45 – $5.57 |