healthcosts.net
ER Visit (level 1, minor) at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$260.40
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.
$434.00
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.
$51.60 with UPMC Work Partners vs $427.09 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 Work Partners | Workers Comp | $51.60 | ↓ -80% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $55.38 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $66.90 | ↓ -74% |
| UPMC Health Plan | Managed Medicare | $84.18 | ↓ -68% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $85.76 | ↓ -67% |
| United Healthcare | Unison Advantage Non Special Needs | $88.15 | ↓ -66% |
| Aetna of PA | Medicare | $88.15 | ↓ -66% |
| United Healthcare | Medicare | $89.83 | ↓ -66% |
| Highmark Wholecare (prev Gateway) | Medicare | $90.66 | ↓ -65% |
| AmeriHealth Caritas | Medicare | $90.67 | ↓ -65% |
| Cigna | Medicare | $90.67 | ↓ -65% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.67 | ↓ -65% |
| Aetna | Medicare | $92.34 | ↓ -65% |
| United Healthcare | Unison Advantage Special Needs | $92.34 | ↓ -65% |
| UPMC Health Plan | Commercial | $124.76 | ↓ -52% |
| United Healthcare | Compass Exchange | $143.22 | ↓ -45% |
| Aetna | Neighborhood Network | $152.33 | ↓ -42% |
| Highmark BCBS of PA | Managed Care - Social Mission | $159.46 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $160.27 | ↓ -38% |
| Aetna | EBR FI | $164.92 | ↓ -37% |
| Aetna | Home Depot Employer Group | $165.79 | ↓ -36% |
| Cigna | NBR ASO/FI | $169.26 | ↓ -35% |
| Aetna | NBR ASO/FI | $169.26 | ↓ -35% |
| Cigna | New Business ASO | $169.26 | ↓ -35% |
| United Healthcare | All Business | $169.26 | ↓ -35% |
| Cigna | EBR | $173.60 | ↓ -33% |
| Cigna | Commercial | $173.60 | ↓ -33% |
| Aetna | EBR ASO | $173.60 | ↓ -33% |
| UPMC Health Plan | CHIP | $176.68 | ↓ -32% |
| Highmark BCBS of PA | Managed Care | $213.55 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Indemnity | $214.65 | ↓ -18% |
| InterGroup | PPO | $217.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $238.70 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $238.70 | ↓ -8% |
| Coventry/First Health | Commercial | $303.80 | ↑ +17% |
| Private Health Care Systems | PPO | $347.20 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $427.09 | ↑ +64% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 1, minor) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $183.60 | $51.60 – $260.10 |
| UPMC Hamot | Erie | $384.60 | $51.60 – $448.70 |
| UPMC Carlisle | Carlisle | $391.20 | $21.05 – $554.20 |
| UPMC Altoona | Altoona | $374.40 | $21.00 – $499.20 |
| UPMC Bedford | Everett | $215.40 | $30.29 – $323.10 |
| UPMC Cole | Coudersport | $136.20 | $18.26 – $103.74 |
| UPMC Community Osteopathic | Harrisburg | $391.20 | $21.05 – $554.20 |
| UPMC Hanover | Hanover | $391.20 | $53.65 – $567.24 |