healthcosts.net
Established Patient Office Visit (level 3) at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$186.60
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.
$311.00
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.
$36.08 with Aetna of PA vs $278.02 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 |
|---|---|---|---|
| Aetna of PA | Medicare | $36.08 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $38.50 | ↓ -79% |
| United Healthcare Community Plan for Families | Unison Kids | $40.25 | ↓ -78% |
| Geisinger | Medicaid/CHIP | $48.65 | ↓ -74% |
| Highmark Wholecare (prev Gateway) | Medicaid | $51.91 | ↓ -72% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $52.78 | ↓ -72% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $54.38 | ↓ -71% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $54.64 | ↓ -71% |
| PA Health & Wellness | PA Medicaid HMO | $59.65 | ↓ -68% |
| Cigna | Commercial | $63.91 | ↓ -66% |
| Cigna | New Business ASO | $63.91 | ↓ -66% |
| Aetna | Medicare | $77.75 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $88.40 | ↓ -53% |
| United Healthcare | Compass Exchange | $102.63 | ↓ -45% |
| Highmark BCBS of PA | Managed Care - Social Mission | $103.80 | ↓ -44% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $104.33 | ↓ -44% |
| Aetna | Neighborhood Network | $109.16 | ↓ -42% |
| Aetna | EBR FI | $118.18 | ↓ -37% |
| Aetna | Home Depot Employer Group | $118.80 | ↓ -36% |
| Aetna | NBR ASO/FI | $121.29 | ↓ -35% |
| Cigna | NBR ASO/FI | $121.29 | ↓ -35% |
| United Healthcare | All Business | $121.29 | ↓ -35% |
| Aetna | EBR ASO | $124.40 | ↓ -33% |
| Cigna | EBR | $124.40 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $139.01 | ↓ -26% |
| Highmark BCBS of PA | Commercial - Indemnity | $139.73 | ↓ -25% |
| Highmark Wholecare (prev Gateway) | Medicare | $155.50 | ↓ -17% |
| InterGroup | PPO | $155.50 | ↓ -17% |
| UPMC Health Plan | CHIP | $155.85 | ↓ -16% |
| Coventry/First Health | Commercial | $217.70 | ↑ +17% |
| Private Health Care Systems | PPO | $248.80 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $278.02 | ↑ +49% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $179.40 | $38.50 – $254.15 |
| UPMC Altoona | Altoona | $230.40 | $20.00 – $307.20 |
| UPMC Bedford | Everett | $121.20 | $36.08 – $181.80 |
| UPMC Cole | Coudersport | $183.00 | $36.75 – $128.00 |
| UPMC Hamot | Erie | $156.60 | $38.50 – $182.70 |
| UPMC Community Osteopathic | Harrisburg | $240.60 | $20.60 – $288.22 |
| UPMC Hanover | Hanover | $61.80 | $19.57 – $89.61 |
| UPMC Horizon-Greenville | Greenville | $216.00 | $36.75 – $306.00 |