Inj proc ankle arthr at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$543.60
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.
$906.00
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.
$27.50 with UPMC Health Plan vs $783.37 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 Health Plan | Managed Medicaid | $27.50 | ↓ -95% |
| United Healthcare Community Plan for Families | Unison Kids | $28.75 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $34.75 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $37.08 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $37.70 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $39.03 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $42.60 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $131.35 | ↓ -76% |
| UPMC Work Partners | Workers Comp | $138.02 | ↓ -75% |
| Aetna | Medicare | $226.50 | ↓ -58% |
| UPMC Health Plan | Commercial | $229.63 | ↓ -58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $292.47 | ↓ -46% |
| United Healthcare | Compass Exchange | $298.98 | ↓ -45% |
| Aetna | Neighborhood Network | $318.01 | ↓ -41% |
| Aetna | EBR FI | $344.28 | ↓ -37% |
| Aetna | Home Depot Employer Group | $346.09 | ↓ -36% |
| Cigna | NBR ASO/FI | $353.34 | ↓ -35% |
| United Healthcare | All Business | $353.34 | ↓ -35% |
| Aetna | NBR ASO/FI | $353.34 | ↓ -35% |
| Cigna | New Business ASO | $353.34 | ↓ -35% |
| Cigna | EBR | $362.40 | ↓ -33% |
| Aetna | EBR ASO | $362.40 | ↓ -33% |
| Cigna | Commercial | $362.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $380.18 | ↓ -30% |
| Highmark BCBS of PA | Managed Care | $391.69 | ↓ -28% |
| UPMC Health Plan | CHIP | $401.97 | ↓ -26% |
| Highmark Wholecare (prev Gateway) | Medicare | $453.00 | ↓ -17% |
| InterGroup | PPO | $453.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $509.17 | ↓ -6% |
| Coventry/First Health | Commercial | $634.20 | ↑ +17% |
| Private Health Care Systems | PPO | $724.80 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $783.37 | ↑ +44% |
Visitor-reported prices
Comments
Inj proc ankle arthr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $405.60 | $31.75 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $405.60 | $32.75 – $574.60 |
| UPMC Hamot | Erie | $543.00 | $27.50 – $138.02 |
| UPMC Northwest | Seneca | $409.20 | $27.50 – $337.70 |
| UPMC Hanover | Hanover | $405.60 | $31.75 – $137.47 |
| UPMC Kane | Kane | $388.80 | $27.50 – $891.82 |
| UPMC Lititz | Lititz | $405.60 | $31.75 – $135.90 |
| UPMC Magee | Pittsburgh | $543.00 | $27.50 – $138.02 |