Ins/rpl pm gen exist dual lead at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$6,828.00
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.
$11,380.00
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.
$1,212.63 with UPMC Work Partners vs $10,975.18 with United Healthcare — 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 Work Partners | Workers Comp | $1,212.63 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,646.97 | ↓ -76% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,667.03 | ↓ -46% |
| United Healthcare | Compass Exchange | $3,755.40 | ↓ -45% |
| Aetna | Neighborhood Network | $3,994.38 | ↓ -42% |
| Aetna | EBR FI | $4,324.40 | ↓ -37% |
| Aetna | Home Depot Employer Group | $4,347.16 | ↓ -36% |
| United Healthcare | All Business | $4,438.20 | ↓ -35% |
| Cigna | NBR ASO/FI | $4,438.20 | ↓ -35% |
| Cigna | New Business ASO | $4,438.20 | ↓ -35% |
| Aetna | NBR ASO/FI | $4,438.20 | ↓ -35% |
| Aetna | EBR ASO | $4,552.00 | ↓ -33% |
| Cigna | EBR | $4,552.00 | ↓ -33% |
| Cigna | Commercial | $4,552.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,766.86 | ↓ -30% |
| Highmark BCBS of PA | Managed Care | $4,911.06 | ↓ -28% |
| UPMC Health Plan | CHIP | $5,149.48 | ↓ -25% |
| UPMC Health Plan | Commercial | $5,581.89 | ↓ -18% |
| InterGroup | PPO | $5,690.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $6,259.00 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $6,259.00 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,384.16 | ↓ -7% |
| Coventry/First Health | Commercial | $7,966.00 | ↑ +17% |
| Private Health Care Systems | PPO | $9,104.00 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $9,822.12 | ↑ +44% |
| UPMC Health Plan | Managed Medicare | $10,004.38 | ↑ +47% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10,192.95 | ↑ +49% |
| United Healthcare | Unison Advantage Non Special Needs | $10,476.31 | ↑ +53% |
| Aetna of PA | Medicare | $10,476.31 | ↑ +53% |
| United Healthcare | Medicare | $10,675.86 | ↑ +56% |
| Highmark Wholecare (prev Gateway) | Medicare | $10,774.64 | ↑ +58% |
| AmeriHealth Caritas | Medicare | $10,775.64 | ↑ +58% |
| Cigna | Medicare | $10,775.64 | ↑ +58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,775.64 | ↑ +58% |
| Aetna | Medicare | $10,975.18 | ↑ +61% |
| United Healthcare | Unison Advantage Special Needs | $10,975.18 | ↑ +61% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm gen exist dual lead at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,344.20 | $1,140.25 – $10,775.64 |
| UPMC Carlisle | Carlisle | $15,540.60 | $1,016.56 – $22,015.85 |
| UPMC Cole | Coudersport | $787.80 | $363.96 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $15,540.60 | $1,016.56 – $22,015.85 |
| UPMC Hamot | Erie | $9,586.80 | $1,212.63 – $14,511.47 |
| UPMC Hanover | Hanover | $15,540.60 | $1,016.56 – $15,996.05 |
| UPMC Lititz | Lititz | $15,540.60 | $1,016.56 – $16,082.45 |
| UPMC Memorial | York | $15,540.60 | $1,016.56 – $16,056.32 |