Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$73,004.40
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.
$121,674.00
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.
$1,602.70 with Highmark BCBS of PA vs $97,339.20 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,602.70 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $3,429.22 | ↓ -95% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,568.47 | ↓ -95% |
| UPMC Health Plan | CHIP | $3,605.28 | ↓ -95% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,638.73 | ↓ -94% |
| Highmark BCBS of PA | Managed Care | $4,779.06 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,212.57 | ↓ -91% |
| Highmark BCBS of PA | UPMC Emergent | $9,558.12 | ↓ -87% |
| UPMC Health Plan | Managed Medicare | $30,649.40 | ↓ -58% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $31,227.11 | ↓ -57% |
| Aetna of PA | Medicare | $32,095.21 | ↓ -56% |
| United Healthcare | Unison Advantage Non Special Needs | $32,095.21 | ↓ -56% |
| United Healthcare | Medicare | $32,706.55 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $33,009.16 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $33,012.22 | ↓ -55% |
| Cigna | Medicare | $33,012.22 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $33,012.22 | ↓ -55% |
| Aetna | Medicare | $33,623.56 | ↓ -54% |
| United Healthcare | Unison Advantage Special Needs | $33,623.56 | ↓ -54% |
| United Healthcare | Compass Exchange | $40,152.42 | ↓ -45% |
| Aetna | Neighborhood Network | $42,707.57 | ↓ -42% |
| Aetna | EBR FI | $46,236.12 | ↓ -37% |
| Aetna | Home Depot Employer Group | $46,479.47 | ↓ -36% |
| Cigna | NBR ASO/FI | $47,452.86 | ↓ -35% |
| United Healthcare | All Business | $47,452.86 | ↓ -35% |
| Aetna | NBR ASO/FI | $47,452.86 | ↓ -35% |
| Cigna | New Business ASO | $47,452.86 | ↓ -35% |
| Aetna | EBR ASO | $48,669.60 | ↓ -33% |
| Cigna | Commercial | $48,669.60 | ↓ -33% |
| Cigna | EBR | $48,669.60 | ↓ -33% |
| UPMC Health Plan | Commercial | $59,681.10 | ↓ -18% |
| InterGroup | PPO | $60,837.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $66,920.70 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $66,920.70 | ↓ -8% |
| Coventry/First Health | Commercial | $85,171.80 | ↑ +17% |
| Private Health Care Systems | PPO | $97,339.20 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $6,433.20 | $1,587.58 – $33,012.22 |
| UPMC Carlisle | Carlisle | $48,933.60 | $1,016.56 – $69,322.60 |
| UPMC Community Osteopathic | Harrisburg | $48,933.60 | $1,016.56 – $69,322.60 |
| UPMC Hamot | Erie | $39,445.80 | $1,587.58 – $44,457.34 |
| UPMC Hanover | Hanover | $48,933.60 | $1,016.56 – $49,005.49 |
| UPMC Lititz | Lititz | $48,933.60 | $1,016.56 – $49,270.19 |
| UPMC Memorial | York | $48,933.60 | $1,016.56 – $49,190.16 |
| UPMC Mercy | Pittsburgh | $41,292.60 | $1,587.58 – $33,623.56 |