Ot re-evaluation patient/family at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$155.40
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.
$259.00
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.
$33.29 with Highmark BCBS of PA vs $248.11 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 | $33.29 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $44.76 | ↓ -71% |
| United Healthcare Community Plan for Families | Unison Kids | $46.79 | ↓ -70% |
| Geisinger | Medicaid/CHIP | $56.56 | ↓ -64% |
| Highmark BCBS of PA | Managed Care - Social Mission | $57.81 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicaid | $60.34 | ↓ -61% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $61.36 | ↓ -61% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $63.52 | ↓ -59% |
| Aetna | Medicare | $64.75 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $66.93 | ↓ -57% |
| PA Health & Wellness | PA Medicaid HMO | $69.34 | ↓ -55% |
| Highmark BCBS of PA | Managed Care | $77.42 | ↓ -50% |
| United Healthcare | Compass Exchange | $85.47 | ↓ -45% |
| Aetna | Neighborhood Network | $90.91 | ↓ -41% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $96.35 | ↓ -38% |
| Aetna | EBR FI | $98.42 | ↓ -37% |
| Aetna | Home Depot Employer Group | $98.94 | ↓ -36% |
| Cigna | NBR ASO/FI | $101.01 | ↓ -35% |
| United Healthcare | All Business | $101.01 | ↓ -35% |
| Aetna | NBR ASO/FI | $101.01 | ↓ -35% |
| Cigna | New Business ASO | $101.01 | ↓ -35% |
| Cigna | EBR | $103.60 | ↓ -33% |
| Aetna | EBR ASO | $103.60 | ↓ -33% |
| Cigna | Commercial | $103.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $129.04 | ↓ -17% |
| InterGroup | PPO | $129.50 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $129.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $154.85 | ↓ -0% |
| Coventry/First Health | Commercial | $181.30 | ↑ +17% |
| UPMC Health Plan | CHIP | $204.46 | ↑ +32% |
| Private Health Care Systems | PPO | $207.20 | ↑ +33% |
| UPMC Health Plan | Commercial | $248.11 | ↑ +60% |
Visitor-reported prices
Comments
Ot re-evaluation patient/family at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $113.40 | $32.98 – $151.20 |
| UPMC Bedford | Everett | $125.40 | $42.72 – $188.10 |
| UPMC Carlisle | Carlisle | $138.60 | $31.65 – $387.00 |
| UPMC Cole | Coudersport | $118.80 | $42.72 – $158.40 |
| UPMC Community Osteopathic | Harrisburg | $138.60 | $46.20 – $204.46 |
| UPMC Hamot | Erie | $147.60 | $32.98 – $121.18 |
| UPMC Northwest | Seneca | $105.00 | $44.76 – $85.58 |
| UPMC Hanover | Hanover | $138.60 | $51.68 – $193.00 |