M/phmtrc alys ishquant/semiq at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$370.20
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.
$617.00
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.
$94.07 with Highmark BCBS of PA vs $656.49 with UPMC Health Plan — 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 | $94.07 | ↓ -75% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $161.78 | ↓ -56% |
| Highmark BCBS of PA | Managed Care - Social Mission | $163.52 | ↓ -56% |
| UPMC Health Plan | Managed Medicare | $163.81 | ↓ -56% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $166.90 | ↓ -55% |
| United Healthcare | Unison Advantage Non Special Needs | $171.54 | ↓ -54% |
| Aetna of PA | Medicare | $171.54 | ↓ -54% |
| United Healthcare | Medicare | $174.81 | ↓ -53% |
| Highmark Wholecare (prev Gateway) | Medicare | $176.42 | ↓ -52% |
| AmeriHealth Caritas | Medicare | $176.44 | ↓ -52% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $176.44 | ↓ -52% |
| Cigna | Medicare | $176.44 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $177.96 | ↓ -52% |
| Aetna | Medicare | $179.71 | ↓ -51% |
| United Healthcare | Unison Advantage Special Needs | $179.71 | ↓ -51% |
| United Healthcare Community Plan for Families | Unison Kids | $186.05 | ↓ -50% |
| United Healthcare | Compass Exchange | $203.61 | ↓ -45% |
| Aetna | Neighborhood Network | $216.57 | ↓ -41% |
| Highmark BCBS of PA | Managed Care | $219.00 | ↓ -41% |
| Geisinger | Medicaid/CHIP | $224.86 | ↓ -39% |
| Aetna | EBR FI | $234.46 | ↓ -37% |
| Aetna | Home Depot Employer Group | $235.69 | ↓ -36% |
| Highmark Wholecare (prev Gateway) | Medicaid | $239.92 | ↓ -35% |
| United Healthcare | All Business | $240.63 | ↓ -35% |
| Cigna | NBR ASO/FI | $240.63 | ↓ -35% |
| Aetna | NBR ASO/FI | $240.63 | ↓ -35% |
| Cigna | New Business ASO | $240.63 | ↓ -35% |
| Cigna | EBR | $246.80 | ↓ -33% |
| Cigna | Commercial | $246.80 | ↓ -33% |
| Aetna | EBR ASO | $246.80 | ↓ -33% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $252.55 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $272.27 | ↓ -26% |
| PA Health & Wellness | PA Medicaid HMO | $275.71 | ↓ -26% |
| UPMC Work Partners | Workers Comp | $279.34 | ↓ -25% |
| UPMC Health Plan | Commercial | $306.08 | ↓ -17% |
| InterGroup | PPO | $308.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $364.64 | ↓ -2% |
| Coventry/First Health | Commercial | $431.90 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $438.01 | ↑ +18% |
| Private Health Care Systems | PPO | $493.60 | ↑ +33% |
| UPMC Health Plan | CHIP | $656.49 | ↑ +77% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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M/phmtrc alys ishquant/semiq at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $463.20 | $93.18 – $617.60 |
| UPMC Carlisle | Carlisle | $337.20 | $76.99 – $477.70 |
| UPMC Cole | Coudersport | $1,052.40 | $53.00 – $1,403.20 |
| UPMC Community Osteopathic | Harrisburg | $337.20 | $112.40 – $656.49 |
| UPMC Hamot | Erie | $426.00 | $93.18 – $279.34 |
| UPMC Northwest | Seneca | $646.80 | $148.16 – $279.34 |
| UPMC Horizon-Greenville | Greenville | $400.20 | $146.27 – $279.34 |
| UPMC Jameson | New Castle | $528.00 | $94.83 – $279.34 |