Pq kyphplsty 1 bdy lumb w/img at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$24,137.40
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.
?
What you pay up front if you don't use insurance.
$40,229.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$4,719.92 with Highmark BCBS of PA vs $32,183.20 with Private Health Care Systems — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $4,719.92 | ↓ -80% |
| UPMC Health Plan | Commercial | $6,531.35 | ↓ -73% |
| UPMC Health Plan | Managed Medicare | $6,829.08 | ↓ -72% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $6,957.80 | ↓ -71% |
| Aetna of PA | Medicare | $7,151.22 | ↓ -70% |
| United Healthcare | Unison Advantage Non Special Needs | $7,151.22 | ↓ -70% |
| United Healthcare | Medicare | $7,287.44 | ↓ -70% |
| Highmark Wholecare (prev Gateway) | Medicare | $7,354.86 | ↓ -70% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $7,355.55 | ↓ -70% |
| AmeriHealth Caritas | Medicare | $7,355.55 | ↓ -70% |
| Cigna | Medicare | $7,355.55 | ↓ -70% |
| Aetna | Medicare | $7,491.76 | ↓ -69% |
| United Healthcare | Unison Advantage Special Needs | $7,491.76 | ↓ -69% |
| UPMC Work Partners | Workers Comp | $9,456.32 | ↓ -61% |
| Highmark BCBS of PA | Managed Care - Social Mission | $10,509.09 | ↓ -56% |
| UPMC Health Plan | CHIP | $11,433.07 | ↓ -53% |
| United Healthcare | Compass Exchange | $13,275.57 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $13,660.99 | ↓ -43% |
| Highmark BCBS of PA | Managed Care | $14,074.25 | ↓ -42% |
| Aetna | Neighborhood Network | $14,120.38 | ↓ -41% |
| Aetna | EBR FI | $15,287.02 | ↓ -37% |
| Aetna | Home Depot Employer Group | $15,367.48 | ↓ -36% |
| Cigna | NBR ASO/FI | $15,689.31 | ↓ -35% |
| United Healthcare | All Business | $15,689.31 | ↓ -35% |
| Aetna | NBR ASO/FI | $15,689.31 | ↓ -35% |
| Cigna | New Business ASO | $15,689.31 | ↓ -35% |
| Cigna | EBR | $16,091.60 | ↓ -33% |
| Aetna | EBR ASO | $16,091.60 | ↓ -33% |
| Cigna | Commercial | $16,091.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $18,295.90 | ↓ -24% |
| InterGroup | PPO | $20,114.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $22,125.95 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $22,125.95 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $28,148.50 | ↑ +17% |
| Coventry/First Health | Commercial | $28,160.30 | ↑ +17% |
| Private Health Care Systems | PPO | $32,183.20 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Pq kyphplsty 1 bdy lumb w/img at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $18,813.00 | $1,016.56 – $26,400.15 |
| UPMC Cole | Coudersport | $866.40 | $400.28 – $9,456.32 |
| UPMC Community Osteopathic | Harrisburg | $18,813.00 | $1,016.56 – $26,400.15 |
| UPMC Hamot | Erie | $17,721.00 | $4,675.40 – $9,905.66 |
| UPMC Hanover | Hanover | $18,813.00 | $1,016.56 – $11,433.07 |
| UPMC Lititz | Lititz | $18,813.00 | $1,016.56 – $11,433.07 |
| UPMC Memorial | York | $18,813.00 | $1,016.56 – $11,433.07 |
| UPMC Passavant-McCandless | Pittsburgh | $7,489.80 | $4,719.92 – $10,995.72 |