Perq plmt bile duct stent at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$13,188.60
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.
$21,981.00
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.
$399.45 with UPMC Health Plan vs $23,090.72 with Highmark BCBS of PA — 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 | Managed Medicaid | $399.45 | ↓ -97% |
| United Healthcare Community Plan for Families | Unison Kids | $417.61 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $504.73 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $538.54 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $547.62 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $566.90 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $618.86 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $3,300.26 | ↓ -75% |
| UPMC Health Plan | Managed Medicare | $5,577.38 | ↓ -58% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $5,682.51 | ↓ -57% |
| United Healthcare | Unison Advantage Non Special Needs | $5,840.48 | ↓ -56% |
| Aetna of PA | Medicare | $5,840.48 | ↓ -56% |
| United Healthcare | Medicare | $5,951.73 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $6,006.79 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $6,007.35 | ↓ -54% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $6,007.35 | ↓ -54% |
| Cigna | Medicare | $6,007.35 | ↓ -54% |
| Aetna | Medicare | $6,118.60 | ↓ -54% |
| United Healthcare | Unison Advantage Special Needs | $6,118.60 | ↓ -54% |
| UPMC Work Partners | Workers Comp | $6,261.36 | ↓ -53% |
| United Healthcare | Compass Exchange | $7,253.73 | ↓ -45% |
| UPMC Health Plan | CHIP | $7,693.35 | ↓ -42% |
| Aetna | Neighborhood Network | $7,715.33 | ↓ -42% |
| Aetna | EBR FI | $8,352.78 | ↓ -37% |
| Aetna | Home Depot Employer Group | $8,396.74 | ↓ -36% |
| United Healthcare | All Business | $8,572.59 | ↓ -35% |
| Cigna | New Business ASO | $8,572.59 | ↓ -35% |
| Cigna | NBR ASO/FI | $8,572.59 | ↓ -35% |
| Aetna | NBR ASO/FI | $8,572.59 | ↓ -35% |
| Highmark BCBS of PA | Managed Care - Social Mission | $8,620.42 | ↓ -35% |
| Cigna | EBR | $8,792.40 | ↓ -33% |
| Cigna | Commercial | $8,792.40 | ↓ -33% |
| Aetna | EBR ASO | $8,792.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $9,552.01 | ↓ -28% |
| UPMC Health Plan | Commercial | $10,781.68 | ↓ -18% |
| InterGroup | PPO | $10,990.50 | ↓ -17% |
| Highmark BCBS of PA | Managed Care | $11,545.36 | ↓ -12% |
| Highmark BCBS of PA | Commercial - Indemnity | $12,792.83 | ↓ -3% |
| Coventry/First Health | Commercial | $15,386.70 | ↑ +17% |
| Private Health Care Systems | PPO | $17,584.80 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $23,090.72 | ↑ +75% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Perq plmt bile duct stent at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $24,852.00 | $399.45 – $8,448.96 |