Removal biliary drg cath at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$3,018.60
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.
$5,031.00
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.
$89.12 with UPMC Health Plan vs $4,024.80 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 Health Plan | Managed Medicaid | $89.12 | ↓ -97% |
| United Healthcare Community Plan for Families | Unison Kids | $93.17 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $112.61 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $120.15 | ↓ -96% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $122.18 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $126.48 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $138.07 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $272.77 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $517.54 | ↓ -83% |
| Highmark BCBS of PA | Managed Care - Social Mission | $607.33 | ↓ -80% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $789.48 | ↓ -74% |
| Highmark BCBS of PA | Managed Care | $813.36 | ↓ -73% |
| UPMC Health Plan | Managed Medicare | $896.26 | ↓ -70% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $913.16 | ↓ -70% |
| United Healthcare | Unison Advantage Non Special Needs | $938.54 | ↓ -69% |
| Aetna of PA | Medicare | $938.54 | ↓ -69% |
| United Healthcare | Medicare | $956.42 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $965.27 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $965.36 | ↓ -68% |
| Cigna | Medicare | $965.36 | ↓ -68% |
| AmeriHealth Caritas | Medicare | $965.36 | ↓ -68% |
| United Healthcare | Unison Advantage Special Needs | $983.24 | ↓ -67% |
| Aetna | Medicare | $983.24 | ↓ -67% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,057.33 | ↓ -65% |
| Highmark BCBS of PA | UPMC Emergent | $1,626.72 | ↓ -46% |
| United Healthcare | Compass Exchange | $1,660.23 | ↓ -45% |
| UPMC Health Plan | Commercial | $1,683.37 | ↓ -44% |
| Aetna | Neighborhood Network | $1,765.88 | ↓ -42% |
| Aetna | EBR FI | $1,911.78 | ↓ -37% |
| Aetna | Home Depot Employer Group | $1,921.84 | ↓ -36% |
| Aetna | NBR ASO/FI | $1,962.09 | ↓ -35% |
| United Healthcare | All Business | $1,962.09 | ↓ -35% |
| Cigna | NBR ASO/FI | $1,962.09 | ↓ -35% |
| Cigna | New Business ASO | $1,962.09 | ↓ -35% |
| Aetna | EBR ASO | $2,012.40 | ↓ -33% |
| Cigna | EBR | $2,012.40 | ↓ -33% |
| Cigna | Commercial | $2,012.40 | ↓ -33% |
| InterGroup | PPO | $2,515.50 | ↓ -17% |
| UPMC Health Plan | CHIP | $2,946.72 | ↓ -2% |
| Coventry/First Health | Commercial | $3,521.70 | ↑ +17% |
| Private Health Care Systems | PPO | $4,024.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Removal biliary drg cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,851.00 | $81.02 – $2,468.00 |
| UPMC Carlisle | Carlisle | $1,663.20 | $102.90 – $2,356.20 |
| UPMC Community Osteopathic | Harrisburg | $1,663.20 | $109.38 – $2,946.72 |
| UPMC Hamot | Erie | $2,349.00 | $89.12 – $1,300.05 |
| UPMC Northwest | Seneca | $1,176.00 | $89.12 – $938.54 |
| UPMC Hanover | Hanover | $1,663.20 | $102.90 – $1,433.04 |
| UPMC Lititz | Lititz | $1,663.20 | $102.90 – $1,440.78 |
| UPMC McKeesport | Mckeesport | $2,457.00 | $89.12 – $983.24 |