healthcosts.net
Knee X-ray at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$436.20
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.
$727.00
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.
$37.20 with UPMC Health Plan vs $581.60 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 | Commercial | $37.20 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $40.91 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $88.10 | ↓ -80% |
| Highmark BCBS of PA | Managed Care - Social Mission | $91.08 | ↓ -79% |
| UPMC Health Plan | Managed Medicare | $101.65 | ↓ -77% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $103.57 | ↓ -76% |
| United Healthcare | Unison Advantage Non Special Needs | $106.45 | ↓ -76% |
| Aetna of PA | Medicare | $106.45 | ↓ -76% |
| United Healthcare | Medicare | $108.48 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -75% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -75% |
| Cigna | Medicare | $109.49 | ↓ -75% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -75% |
| Aetna | Medicare | $111.52 | ↓ -74% |
| United Healthcare | Unison Advantage Special Needs | $111.52 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $118.40 | ↓ -73% |
| Highmark BCBS of PA | Managed Care | $121.98 | ↓ -72% |
| UPMC Health Plan | CHIP | $135.24 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Indemnity | $158.57 | ↓ -64% |
| United Healthcare | Compass Exchange | $239.91 | ↓ -45% |
| Highmark BCBS of PA | UPMC Emergent | $243.96 | ↓ -44% |
| Aetna | Neighborhood Network | $255.18 | ↓ -41% |
| Aetna | EBR FI | $276.26 | ↓ -37% |
| Aetna | Home Depot Employer Group | $277.71 | ↓ -36% |
| Cigna | NBR ASO/FI | $283.53 | ↓ -35% |
| Aetna | NBR ASO/FI | $283.53 | ↓ -35% |
| Cigna | New Business ASO | $283.53 | ↓ -35% |
| United Healthcare | All Business | $283.53 | ↓ -35% |
| Cigna | EBR | $290.80 | ↓ -33% |
| Cigna | Commercial | $290.80 | ↓ -33% |
| Aetna | EBR ASO | $290.80 | ↓ -33% |
| InterGroup | PPO | $363.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $399.85 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $399.85 | ↓ -8% |
| Coventry/First Health | Commercial | $508.90 | ↑ +17% |
| Private Health Care Systems | PPO | $581.60 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Knee X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $37.53 – $594.15 |
| UPMC Hamot | Erie | $473.40 | $25.96 – $552.30 |
| UPMC Carlisle | Carlisle | $262.80 | $29.37 – $589.04 |
| UPMC Altoona | Altoona | $186.60 | $40.52 – $248.80 |
| UPMC Bedford | Everett | $133.20 | $36.58 – $199.80 |
| UPMC Cole | Coudersport | $215.40 | $42.48 – $287.20 |
| UPMC Community Osteopathic | Harrisburg | $262.80 | $29.37 – $372.30 |
| UPMC Hanover | Hanover | $262.80 | $29.37 – $589.04 |