Duplex scan bilateral study 93985 at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$791.40
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.
$1,319.00
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.
$122.89 with Highmark BCBS of PA vs $1,055.20 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $122.89 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $225.76 | ↓ -71% |
| UPMC Health Plan | Managed Medicare | $231.07 | ↓ -71% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $235.43 | ↓ -70% |
| United Healthcare Community Plan for Families | Unison Kids | $236.03 | ↓ -70% |
| Aetna of PA | Medicare | $241.97 | ↓ -69% |
| United Healthcare | Unison Advantage Non Special Needs | $241.97 | ↓ -69% |
| United Healthcare | Medicare | $246.58 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $248.86 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $248.89 | ↓ -69% |
| Cigna | Medicare | $248.89 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $248.89 | ↓ -69% |
| United Healthcare | Unison Advantage Special Needs | $253.50 | ↓ -68% |
| Aetna | Medicare | $253.50 | ↓ -68% |
| Geisinger | Medicaid/CHIP | $285.26 | ↓ -64% |
| Highmark Wholecare (prev Gateway) | Medicaid | $304.37 | ↓ -62% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $309.50 | ↓ -61% |
| UPMC Work Partners | Workers Comp | $310.56 | ↓ -61% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $320.40 | ↓ -60% |
| Highmark BCBS of PA | Managed Care - Social Mission | $321.00 | ↓ -59% |
| PA Health & Wellness | PA Medicaid HMO | $349.77 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $355.69 | ↓ -55% |
| Highmark BCBS of PA | Managed Care | $429.92 | ↓ -46% |
| United Healthcare | Compass Exchange | $435.27 | ↓ -45% |
| UPMC Health Plan | CHIP | $461.65 | ↓ -42% |
| Aetna | Neighborhood Network | $462.97 | ↓ -41% |
| Highmark BCBS of PA | Commercial - Indemnity | $476.37 | ↓ -40% |
| Aetna | EBR FI | $501.22 | ↓ -37% |
| Aetna | Home Depot Employer Group | $503.86 | ↓ -36% |
| Aetna | NBR ASO/FI | $514.41 | ↓ -35% |
| Cigna | NBR ASO/FI | $514.41 | ↓ -35% |
| Cigna | New Business ASO | $514.41 | ↓ -35% |
| United Healthcare | All Business | $514.41 | ↓ -35% |
| Aetna | EBR ASO | $527.60 | ↓ -33% |
| Cigna | EBR | $527.60 | ↓ -33% |
| Cigna | Commercial | $527.60 | ↓ -33% |
| UPMC Health Plan | Commercial | $646.97 | ↓ -18% |
| InterGroup | PPO | $659.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $859.83 | ↑ +9% |
| Coventry/First Health | Commercial | $923.30 | ↑ +17% |
| Private Health Care Systems | PPO | $1,055.20 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Duplex scan bilateral study 93985 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $814.20 | $83.15 – $1,221.30 |
| UPMC Carlisle | Carlisle | $692.40 | $158.10 – $980.90 |
| UPMC Community Osteopathic | Harrisburg | $692.40 | $227.90 – $980.90 |
| UPMC Hamot | Erie | $615.00 | $121.73 – $345.98 |
| UPMC Northwest | Seneca | $1,662.00 | $209.00 – $310.56 |
| UPMC Hanover | Hanover | $692.40 | $227.90 – $369.47 |
| UPMC Horizon-Greenville | Greenville | $1,393.20 | $206.32 – $310.56 |
| UPMC Jameson | New Castle | $766.80 | $123.88 – $310.56 |