Prp i/hern init block >5 yr at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$9,009.00
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.
$15,015.00
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.
$1,326.21 with UPMC Work Partners vs $12,012.00 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $1,326.21 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,646.97 | ↓ -82% |
| UPMC Health Plan | Managed Medicare | $3,373.62 | ↓ -63% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,437.21 | ↓ -62% |
| Aetna of PA | Medicare | $3,532.77 | ↓ -61% |
| United Healthcare | Unison Advantage Non Special Needs | $3,532.77 | ↓ -61% |
| United Healthcare | Medicare | $3,600.06 | ↓ -60% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,633.37 | ↓ -60% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,633.70 | ↓ -60% |
| Cigna | Medicare | $3,633.70 | ↓ -60% |
| AmeriHealth Caritas | Medicare | $3,633.70 | ↓ -60% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,667.03 | ↓ -59% |
| United Healthcare | Unison Advantage Special Needs | $3,700.99 | ↓ -59% |
| Aetna | Medicare | $3,700.99 | ↓ -59% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,766.86 | ↓ -47% |
| Highmark BCBS of PA | Managed Care | $4,911.06 | ↓ -45% |
| United Healthcare | Compass Exchange | $4,954.95 | ↓ -45% |
| UPMC Health Plan | CHIP | $5,151.27 | ↓ -43% |
| Aetna | Neighborhood Network | $5,270.27 | ↓ -41% |
| Aetna | EBR FI | $5,705.70 | ↓ -37% |
| Aetna | Home Depot Employer Group | $5,735.73 | ↓ -36% |
| Cigna | NBR ASO/FI | $5,855.85 | ↓ -35% |
| United Healthcare | All Business | $5,855.85 | ↓ -35% |
| Aetna | NBR ASO/FI | $5,855.85 | ↓ -35% |
| Cigna | New Business ASO | $5,855.85 | ↓ -35% |
| Cigna | EBR | $6,006.00 | ↓ -33% |
| Aetna | EBR ASO | $6,006.00 | ↓ -33% |
| Cigna | Commercial | $6,006.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $6,384.16 | ↓ -29% |
| UPMC Health Plan | Commercial | $7,364.86 | ↓ -18% |
| InterGroup | PPO | $7,507.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $8,258.25 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $8,258.25 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $9,822.12 | ↑ +9% |
| Coventry/First Health | Commercial | $10,510.50 | ↑ +17% |
| Private Health Care Systems | PPO | $12,012.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Prp i/hern init block >5 yr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $883.80 | $408.32 – $1,677.17 |
| UPMC Community Osteopathic | Harrisburg | $1,536.60 | $114.60 – $5,151.27 |
| UPMC Mercy | Pittsburgh | $8,917.80 | $1,348.02 – $3,700.99 |
| UPMC Passavant-McCandless | Pittsburgh | $9,925.80 | $1,326.21 – $3,700.99 |
| UPMC Presbyterian | Pittsburgh | $12,411.60 | $931.20 – $3,700.99 |
| UPMC Somerset | Somerset | $1,536.60 | $557.75 – $3,364.54 |
| Uniontown Hospital | Uniontown | $2,236.00 | $3,470.33 – $8,085.87 |
| UPMC Altoona | Altoona | not published | $1,222.76 – $3,633.70 |