Reduction of procidentia 45900 at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,021.60
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.
$5,036.00
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.
$388.83 with UPMC Work Partners vs $4,028.80 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 | $388.83 | ↓ -87% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $550.23 | ↓ -82% |
| UPMC Health Plan | Managed Medicare | $871.56 | ↓ -71% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $887.98 | ↓ -71% |
| Aetna of PA | Medicare | $912.67 | ↓ -70% |
| United Healthcare | Unison Advantage Non Special Needs | $912.67 | ↓ -70% |
| United Healthcare | Medicare | $930.05 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↓ -69% |
| Cigna | Medicare | $938.75 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $938.75 | ↓ -69% |
| United Healthcare | Unison Advantage Special Needs | $956.13 | ↓ -68% |
| Aetna | Medicare | $956.13 | ↓ -68% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,225.10 | ↓ -59% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,592.54 | ↓ -47% |
| Highmark BCBS of PA | Managed Care | $1,640.71 | ↓ -46% |
| United Healthcare | Compass Exchange | $1,661.88 | ↓ -45% |
| UPMC Health Plan | CHIP | $1,732.42 | ↓ -43% |
| Aetna | Neighborhood Network | $1,767.64 | ↓ -41% |
| Aetna | EBR FI | $1,913.68 | ↓ -37% |
| Aetna | Home Depot Employer Group | $1,923.75 | ↓ -36% |
| Cigna | NBR ASO/FI | $1,964.04 | ↓ -35% |
| United Healthcare | All Business | $1,964.04 | ↓ -35% |
| Aetna | NBR ASO/FI | $1,964.04 | ↓ -35% |
| Cigna | New Business ASO | $1,964.04 | ↓ -35% |
| Cigna | EBR | $2,014.40 | ↓ -33% |
| Aetna | EBR ASO | $2,014.40 | ↓ -33% |
| Cigna | Commercial | $2,014.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,132.85 | ↓ -29% |
| UPMC Health Plan | Commercial | $2,470.16 | ↓ -18% |
| InterGroup | PPO | $2,518.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $2,769.80 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $2,769.80 | ↓ -8% |
| Highmark BCBS of PA | UPMC Emergent | $3,281.43 | ↑ +9% |
| Coventry/First Health | Commercial | $3,525.20 | ↑ +17% |
| Private Health Care Systems | PPO | $4,028.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Reduction of procidentia 45900 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,515.40 | $464.80 – $4,687.20 |
| UPMC Hamot | Erie | $3,449.40 | $388.83 – $1,264.19 |
| UPMC Horizon-Greenville | Greenville | $2,301.00 | $218.22 – $1,060.34 |
| UPMC Jameson | New Castle | $2,374.20 | $218.22 – $1,173.43 |
| UPMC Magee | Pittsburgh | $909.00 | $388.83 – $956.13 |
| UPMC McKeesport | Mckeesport | $2,870.40 | $388.83 – $956.13 |
| UPMC Mercy | Pittsburgh | $2,236.20 | $232.60 – $956.13 |
| UPMC Passavant-McCandless | Pittsburgh | $2,571.60 | $388.83 – $956.13 |