Foam drg >16<=48 sq in without b at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$14.40
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.
$24.00
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.
$6.00 with Aetna vs $274.98 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 | Medicare | $6.00 | ↓ -58% |
| United Healthcare | Compass Exchange | $7.92 | ↓ -45% |
| Aetna | Neighborhood Network | $8.42 | ↓ -42% |
| Aetna | EBR FI | $9.12 | ↓ -37% |
| Aetna | Home Depot Employer Group | $9.17 | ↓ -36% |
| Cigna | NBR ASO/FI | $9.36 | ↓ -35% |
| Aetna | NBR ASO/FI | $9.36 | ↓ -35% |
| Cigna | New Business ASO | $9.36 | ↓ -35% |
| United Healthcare | All Business | $9.36 | ↓ -35% |
| Aetna | EBR ASO | $9.60 | ↓ -33% |
| Cigna | EBR | $9.60 | ↓ -33% |
| Cigna | Commercial | $9.60 | ↓ -33% |
| InterGroup | PPO | $12.00 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $13.20 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $13.20 | ↓ -8% |
| Coventry/First Health | Commercial | $16.80 | ↑ +17% |
| Private Health Care Systems | PPO | $19.20 | ↑ +33% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $35.65 | ↑ +148% |
| UPMC Work Partners | Workers Comp | $45.90 | ↑ +219% |
| Highmark BCBS of PA | Managed Care - Social Mission | $102.67 | ↑ +613% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $103.19 | ↑ +617% |
| UPMC Health Plan | CHIP | $111.44 | ↑ +674% |
| UPMC Health Plan | Commercial | $135.23 | ↑ +839% |
| Highmark BCBS of PA | Managed Care | $137.49 | ↑ +855% |
| Highmark BCBS of PA | Commercial - Indemnity | $138.20 | ↑ +860% |
| Highmark BCBS of PA | UPMC Emergent | $274.98 | ↑ +1810% |
Visitor-reported prices
Comments
Foam drg >16<=48 sq in without b at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $15.00 | $35.32 – $45.90 |
| UPMC Mercy | Pittsburgh | $171.60 | $35.32 – $88.00 |
| UPMC Passavant-McCandless | Pittsburgh | $21.60 | $35.65 – $161.71 |
| UPMC Presbyterian | Pittsburgh | $102.00 | $21.53 – $180.18 |
| UPMC Williamsport | Williamsport | $21.60 | $22.96 – $50.70 |