Observation direct referral from physician office for admission at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$130.20
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.
$217.00
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.
$31.88 with UPMC Health Plan vs $4,590.86 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 |
|---|---|---|---|
| UPMC Health Plan | CHIP | $31.88 | ↓ -76% |
| UPMC Health Plan | Managed Medicaid | $31.88 | ↓ -76% |
| United Healthcare | Compass Exchange | $71.61 | ↓ -45% |
| Aetna | Neighborhood Network | $76.17 | ↓ -41% |
| Aetna | EBR FI | $82.46 | ↓ -37% |
| Aetna | Home Depot Employer Group | $82.89 | ↓ -36% |
| Aetna | NBR ASO/FI | $84.63 | ↓ -35% |
| Cigna | New Business ASO | $84.63 | ↓ -35% |
| Cigna | NBR ASO/FI | $84.63 | ↓ -35% |
| United Healthcare | All Business | $84.63 | ↓ -35% |
| Aetna | EBR ASO | $86.80 | ↓ -33% |
| Cigna | EBR | $86.80 | ↓ -33% |
| Cigna | Commercial | $86.80 | ↓ -33% |
| InterGroup | PPO | $108.50 | ↓ -17% |
| Coventry/First Health | Commercial | $151.90 | ↑ +17% |
| Private Health Care Systems | PPO | $173.60 | ↑ +33% |
| UPMC Health Plan | Managed Medicare | $586.10 | ↑ +350% |
| United Healthcare | Unison Advantage Non Special Needs | $613.75 | ↑ +371% |
| Aetna of PA | Medicare | $613.75 | ↑ +371% |
| United Healthcare | Medicare | $625.44 | ↑ +380% |
| Highmark Wholecare (prev Gateway) | Medicare | $631.22 | ↑ +385% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $631.28 | ↑ +385% |
| AmeriHealth Caritas | Medicare | $631.28 | ↑ +385% |
| Cigna | Medicare | $631.28 | ↑ +385% |
| Aetna | Medicare | $642.97 | ↑ +394% |
| United Healthcare | Unison Advantage Special Needs | $642.97 | ↑ +394% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $679.00 | ↑ +422% |
| United Healthcare Community Plan for Families | Unison Kids | $747.00 | ↑ +474% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $2,064.00 | ↑ +1485% |
| PA Health & Wellness | PA Medicaid HMO | $2,137.42 | ↑ +1542% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $2,137.43 | ↑ +1542% |
| Geisinger | Medicaid/CHIP | $2,207.16 | ↑ +1595% |
| Highmark Wholecare (prev Gateway) | Medicaid | $2,569.10 | ↑ +1873% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,938.52 | ↑ +2925% |
| UPMC Health Plan | Commercial | $4,590.86 | ↑ +3426% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $117.00 | $27.00 – $2,064.00 |
| UPMC Bedford | Everett | $166.20 | $31.88 – $2,207.16 |
| UPMC Carlisle | Carlisle | $420.00 | $95.90 – $2,064.00 |
| UPMC Cole | Coudersport | $84.00 | $38.81 – $112.00 |
| UPMC Community Osteopathic | Harrisburg | $420.00 | $169.40 – $3,000.00 |
| UPMC Hamot | Erie | $138.60 | $674.61 – $728.58 |
| UPMC Northwest | Seneca | $112.80 | $31.88 – $631.28 |
| UPMC Hanover | Hanover | $420.00 | $579.83 – $937.10 |