Drainage of rectal abscess 45020 at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,324.00
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.
$5,540.00
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.
$165.55 with UPMC Health Plan vs $4,432.00 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 | $165.55 | ↓ -95% |
| United Healthcare Community Plan for Families | Unison Kids | $173.07 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $209.18 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $223.19 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $226.95 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $234.95 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $256.48 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $698.52 | ↓ -79% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $736.75 | ↓ -78% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,640.41 | ↓ -51% |
| United Healthcare | Compass Exchange | $1,828.20 | ↓ -45% |
| Aetna | Neighborhood Network | $1,944.54 | ↓ -42% |
| Aetna | EBR FI | $2,105.20 | ↓ -37% |
| Aetna | Home Depot Employer Group | $2,116.28 | ↓ -36% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,132.40 | ↓ -36% |
| United Healthcare | All Business | $2,160.60 | ↓ -35% |
| Cigna | New Business ASO | $2,160.60 | ↓ -35% |
| Cigna | NBR ASO/FI | $2,160.60 | ↓ -35% |
| Aetna | NBR ASO/FI | $2,160.60 | ↓ -35% |
| Highmark BCBS of PA | Managed Care | $2,196.91 | ↓ -34% |
| Cigna | EBR | $2,216.00 | ↓ -33% |
| Cigna | Commercial | $2,216.00 | ↓ -33% |
| Aetna | EBR ASO | $2,216.00 | ↓ -33% |
| UPMC Health Plan | CHIP | $2,315.66 | ↓ -30% |
| UPMC Health Plan | Managed Medicare | $2,621.60 | ↓ -21% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $2,671.01 | ↓ -20% |
| UPMC Health Plan | Commercial | $2,717.37 | ↓ -18% |
| Aetna of PA | Medicare | $2,745.27 | ↓ -17% |
| United Healthcare | Unison Advantage Non Special Needs | $2,745.27 | ↓ -17% |
| InterGroup | PPO | $2,770.00 | ↓ -17% |
| United Healthcare | Medicare | $2,797.56 | ↓ -16% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,823.44 | ↓ -15% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,823.70 | ↓ -15% |
| Cigna | Medicare | $2,823.70 | ↓ -15% |
| AmeriHealth Caritas | Medicare | $2,823.70 | ↓ -15% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,855.88 | ↓ -14% |
| Aetna | Medicare | $2,875.99 | ↓ -13% |
| United Healthcare | Unison Advantage Special Needs | $2,875.99 | ↓ -13% |
| Coventry/First Health | Commercial | $3,878.00 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $4,393.81 | ↑ +32% |
| Private Health Care Systems | PPO | $4,432.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Drainage of rectal abscess 45020 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $4,045.80 | $165.55 – $3,802.67 |
| UPMC Muncy | Muncy | $5,376.00 | $165.55 – $869.12 |
| UPMC Passavant-McCandless | Pittsburgh | $3,769.20 | $165.55 – $2,875.99 |
| UPMC Wellsboro | Wellsboro | $6,501.60 | $165.55 – $869.12 |
| UPMC Williamsport | Williamsport | $5,376.00 | $165.55 – $2,797.56 |
| UPMC St. Margaret | Pittsburgh | not published | $165.55 – $2,875.99 |