Inj., guselkumab, 1 mg at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$695.20
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.
$869.00
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.
$47.97 with UPMC Health Plan vs $695.20 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $47.97 | ↓ -93% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $65.72 | ↓ -91% |
| United Healthcare | Compass Exchange | $73.52 | ↓ -89% |
| United Healthcare | All Business | $73.52 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $75.97 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $75.97 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $75.97 | ↓ -89% |
| PA Health & Wellness | PA Medicaid HMO | $75.97 | ↓ -89% |
| UPMC Health Plan | Managed Medicare | $76.18 | ↓ -89% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $77.61 | ↓ -89% |
| Aetna of PA | Medicare | $79.77 | ↓ -89% |
| United Healthcare | Unison Advantage Non Special Needs | $79.77 | ↓ -89% |
| United Healthcare | Medicare | $81.29 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $82.04 | ↓ -88% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $82.05 | ↓ -88% |
| AmeriHealth Caritas | Medicare | $82.05 | ↓ -88% |
| Cigna | Medicare | $82.05 | ↓ -88% |
| United Healthcare | Unison Advantage Special Needs | $83.57 | ↓ -88% |
| Aetna | Medicare | $83.57 | ↓ -88% |
| UPMC Health Plan | Commercial | $93.45 | ↓ -87% |
| UPMC Work Partners | Workers Comp | $103.93 | ↓ -85% |
| Highmark BCBS of PA | Managed Care - Social Mission | $189.23 | ↓ -73% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $190.20 | ↓ -73% |
| Highmark BCBS of PA | Managed Care | $253.42 | ↓ -64% |
| Highmark BCBS of PA | Commercial - Indemnity | $254.73 | ↓ -63% |
| UPMC Health Plan | CHIP | $304.15 | ↓ -56% |
| Aetna | Neighborhood Network | $305.02 | ↓ -56% |
| Aetna | EBR FI | $330.22 | ↓ -53% |
| Aetna | Home Depot Employer Group | $331.96 | ↓ -52% |
| Aetna | NBR ASO/FI | $338.91 | ↓ -51% |
| Cigna | NBR ASO/FI | $338.91 | ↓ -51% |
| Cigna | New Business ASO | $338.91 | ↓ -51% |
| Aetna | EBR ASO | $347.60 | ↓ -50% |
| Cigna | Commercial | $347.60 | ↓ -50% |
| Cigna | EBR | $347.60 | ↓ -50% |
| InterGroup | PPO | $434.50 | ↓ -38% |
| Highmark BCBS of PA | UPMC Emergent | $506.84 | ↓ -27% |
| Coventry/First Health | Commercial | $608.30 | ↓ -13% |
| Private Health Care Systems | PPO | $695.20 | ↑ +0% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Inj., guselkumab, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| AHN WEXFORD HOSPITAL | WEXFORD | not published | $48.37 – $157.21 |
| GROVE CITY HOSPITAL | GROVE CITY | not published | $60.03 – $157.21 |