Njx px nfrosgrm &/urtrgrm at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,726.20
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.
$2,877.00
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.
$353.81 with Highmark BCBS of PA vs $2,301.60 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $353.81 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $638.07 | ↓ -63% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $650.10 | ↓ -62% |
| United Healthcare | Unison Advantage Non Special Needs | $668.17 | ↓ -61% |
| Aetna of PA | Medicare | $668.17 | ↓ -61% |
| UPMC Work Partners | Workers Comp | $671.26 | ↓ -61% |
| United Healthcare | Medicare | $680.89 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $687.19 | ↓ -60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $687.26 | ↓ -60% |
| Cigna | Medicare | $687.26 | ↓ -60% |
| AmeriHealth Caritas | Medicare | $687.26 | ↓ -60% |
| Aetna | Medicare | $699.99 | ↓ -59% |
| United Healthcare | Unison Advantage Special Needs | $699.99 | ↓ -59% |
| Highmark BCBS of PA | Managed Care - Social Mission | $787.78 | ↓ -54% |
| United Healthcare | Compass Exchange | $949.41 | ↓ -45% |
| Aetna | Neighborhood Network | $1,009.83 | ↓ -41% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,024.05 | ↓ -41% |
| Highmark BCBS of PA | Managed Care | $1,055.03 | ↓ -39% |
| Aetna | EBR FI | $1,093.26 | ↓ -37% |
| Aetna | Home Depot Employer Group | $1,099.01 | ↓ -36% |
| Cigna | NBR ASO/FI | $1,122.03 | ↓ -35% |
| United Healthcare | All Business | $1,122.03 | ↓ -35% |
| Aetna | NBR ASO/FI | $1,122.03 | ↓ -35% |
| Cigna | New Business ASO | $1,122.03 | ↓ -35% |
| Aetna | EBR ASO | $1,150.80 | ↓ -33% |
| Cigna | Commercial | $1,150.80 | ↓ -33% |
| Cigna | EBR | $1,150.80 | ↓ -33% |
| UPMC Health Plan | Commercial | $1,280.60 | ↓ -26% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,371.49 | ↓ -21% |
| InterGroup | PPO | $1,438.50 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $1,582.35 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $1,582.35 | ↓ -8% |
| Coventry/First Health | Commercial | $2,013.90 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $2,110.06 | ↑ +22% |
| UPMC Health Plan | CHIP | $2,241.68 | ↑ +30% |
| Private Health Care Systems | PPO | $2,301.60 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Njx px nfrosgrm &/urtrgrm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,629.00 | $350.48 – $2,172.00 |
| UPMC Bedford | Everett | $4,134.00 | $229.60 – $6,201.00 |
| UPMC Carlisle | Carlisle | $1,266.00 | $289.07 – $1,793.50 |
| UPMC Community Osteopathic | Harrisburg | $1,266.00 | $422.00 – $2,241.68 |
| UPMC Hamot | Erie | $1,804.80 | $350.48 – $925.53 |
| UPMC Northwest | Seneca | $908.40 | $577.11 – $687.26 |
| UPMC Hanover | Hanover | $1,266.00 | $631.25 – $2,241.68 |
| UPMC Lititz | Lititz | $1,266.00 | $634.67 – $2,241.68 |