healthcosts.net
ER Visit (level 5, high severity) at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,371.00
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.
$2,285.00
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.
$152.61 with UPMC Health Plan vs $1,828.00 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 | $152.61 | ↓ -89% |
| United Healthcare Community Plan for Families | Unison Kids | $159.55 | ↓ -88% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $175.87 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $192.83 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $205.75 | ↓ -85% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $209.22 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $216.59 | ↓ -84% |
| PA Health & Wellness | PA Medicaid HMO | $236.44 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $290.02 | ↓ -79% |
| UPMC Health Plan | Commercial | $386.25 | ↓ -72% |
| Highmark BCBS of PA | Managed Care - Social Mission | $506.42 | ↓ -63% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $509.01 | ↓ -63% |
| UPMC Health Plan | CHIP | $547.01 | ↓ -60% |
| UPMC Health Plan | Managed Medicare | $586.10 | ↓ -57% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $597.15 | ↓ -56% |
| United Healthcare | Unison Advantage Non Special Needs | $613.75 | ↓ -55% |
| Aetna of PA | Medicare | $613.75 | ↓ -55% |
| United Healthcare | Medicare | $625.44 | ↓ -54% |
| Highmark Wholecare (prev Gateway) | Medicare | $631.22 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $631.28 | ↓ -54% |
| Cigna | Medicare | $631.28 | ↓ -54% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $631.28 | ↓ -54% |
| Aetna | Medicare | $642.97 | ↓ -53% |
| United Healthcare | Unison Advantage Special Needs | $642.97 | ↓ -53% |
| Highmark BCBS of PA | Managed Care | $678.20 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Indemnity | $681.71 | ↓ -50% |
| United Healthcare | Compass Exchange | $754.05 | ↓ -45% |
| Aetna | Neighborhood Network | $802.03 | ↓ -42% |
| Aetna | EBR FI | $868.30 | ↓ -37% |
| Aetna | Home Depot Employer Group | $872.87 | ↓ -36% |
| Cigna | NBR ASO/FI | $891.15 | ↓ -35% |
| Aetna | NBR ASO/FI | $891.15 | ↓ -35% |
| Cigna | New Business ASO | $891.15 | ↓ -35% |
| United Healthcare | All Business | $891.15 | ↓ -35% |
| Cigna | EBR | $914.00 | ↓ -33% |
| Cigna | Commercial | $914.00 | ↓ -33% |
| Aetna | EBR ASO | $914.00 | ↓ -33% |
| InterGroup | PPO | $1,142.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $1,356.39 | ↓ -1% |
| Coventry/First Health | Commercial | $1,599.50 | ↑ +17% |
| Private Health Care Systems | PPO | $1,828.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,798.20 | $152.61 – $2,547.45 |
| UPMC Hamot | Erie | $2,165.40 | $152.61 – $2,526.30 |
| UPMC Carlisle | Carlisle | $1,828.80 | $65.00 – $2,590.80 |
| UPMC Altoona | Altoona | $1,449.00 | $174.21 – $1,932.00 |
| UPMC Bedford | Everett | $903.60 | $145.68 – $1,355.40 |
| UPMC Cole | Coudersport | $630.00 | $56.38 – $553.93 |
| UPMC Community Osteopathic | Harrisburg | $1,828.80 | $65.00 – $645.31 |
| UPMC Hanover | Hanover | $1,828.80 | $152.61 – $2,651.76 |