Inj proc lumbr disk ea lvl at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$5,860.20
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.
$9,767.00
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.
$167.89 with UPMC Health Plan vs $7,813.60 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 | $167.89 | ↓ -97% |
| United Healthcare Community Plan for Families | Unison Kids | $175.52 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $212.14 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $226.35 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $230.17 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $238.27 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $260.11 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $513.12 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,040.78 | ↓ -82% |
| UPMC Health Plan | Commercial | $1,868.08 | ↓ -68% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,317.34 | ↓ -60% |
| Aetna | Medicare | $2,441.75 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,012.36 | ↓ -49% |
| Highmark BCBS of PA | Managed Care | $3,103.49 | ↓ -47% |
| United Healthcare | Compass Exchange | $3,223.11 | ↓ -45% |
| UPMC Health Plan | CHIP | $3,270.06 | ↓ -44% |
| Aetna | Neighborhood Network | $3,428.22 | ↓ -41% |
| Aetna | EBR FI | $3,711.46 | ↓ -37% |
| Aetna | Home Depot Employer Group | $3,730.99 | ↓ -36% |
| Cigna | NBR ASO/FI | $3,809.13 | ↓ -35% |
| Aetna | NBR ASO/FI | $3,809.13 | ↓ -35% |
| United Healthcare | All Business | $3,809.13 | ↓ -35% |
| Cigna | New Business ASO | $3,809.13 | ↓ -35% |
| Aetna | EBR ASO | $3,906.80 | ↓ -33% |
| Cigna | Commercial | $3,906.80 | ↓ -33% |
| Cigna | EBR | $3,906.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,034.40 | ↓ -31% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,883.50 | ↓ -17% |
| InterGroup | PPO | $4,883.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $6,206.98 | ↑ +6% |
| Coventry/First Health | Commercial | $6,836.90 | ↑ +17% |
| Private Health Care Systems | PPO | $7,813.60 | ↑ +33% |
Visitor-reported prices
Comments
Inj proc lumbr disk ea lvl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $3,214.20 | $193.84 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $3,214.20 | $206.05 – $4,553.45 |
| UPMC Hanover | Hanover | $3,214.20 | $193.84 – $1,016.56 |
| UPMC Lititz | Lititz | $3,214.20 | $137.69 – $1,016.56 |
| UPMC Memorial | York | $3,214.20 | $137.69 – $1,016.56 |
| UPMC Presbyterian | Pittsburgh | $6,966.00 | $167.89 – $1,040.78 |
| UPMC Somerset | Somerset | $3,214.20 | $167.89 – $1,020.54 |