Removal/replacement ppm generator dual lead system at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$30,141.60
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.
$50,236.00
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.
$452.20 with Highmark BCBS of PA vs $40,188.80 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $452.20 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $518.50 | ↓ -98% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,006.84 | ↓ -97% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,308.81 | ↓ -96% |
| Highmark BCBS of PA | Managed Care | $1,348.40 | ↓ -96% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,752.86 | ↓ -94% |
| Highmark BCBS of PA | UPMC Emergent | $2,696.81 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $10,004.38 | ↓ -67% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10,192.95 | ↓ -66% |
| Aetna of PA | Medicare | $10,476.31 | ↓ -65% |
| United Healthcare | Unison Advantage Non Special Needs | $10,476.31 | ↓ -65% |
| United Healthcare | Medicare | $10,675.86 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicare | $10,774.64 | ↓ -64% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,775.64 | ↓ -64% |
| Cigna | Medicare | $10,775.64 | ↓ -64% |
| AmeriHealth Caritas | Medicare | $10,775.64 | ↓ -64% |
| United Healthcare | Unison Advantage Special Needs | $10,975.18 | ↓ -64% |
| Aetna | Medicare | $10,975.18 | ↓ -64% |
| UPMC Health Plan | Commercial | $14,989.22 | ↓ -50% |
| United Healthcare | Compass Exchange | $16,577.88 | ↓ -45% |
| Aetna | Neighborhood Network | $17,632.84 | ↓ -41% |
| Aetna | EBR FI | $19,089.68 | ↓ -37% |
| Aetna | Home Depot Employer Group | $19,190.15 | ↓ -36% |
| Cigna | NBR ASO/FI | $19,592.04 | ↓ -35% |
| United Healthcare | All Business | $19,592.04 | ↓ -35% |
| Aetna | NBR ASO/FI | $19,592.04 | ↓ -35% |
| Cigna | New Business ASO | $19,592.04 | ↓ -35% |
| Cigna | EBR | $20,094.40 | ↓ -33% |
| Aetna | EBR ASO | $20,094.40 | ↓ -33% |
| Cigna | Commercial | $20,094.40 | ↓ -33% |
| InterGroup | PPO | $25,118.00 | ↓ -17% |
| UPMC Health Plan | CHIP | $26,238.52 | ↓ -13% |
| PA Health & Wellness | PA Medicaid HMO | $27,629.80 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $27,629.80 | ↓ -8% |
| Coventry/First Health | Commercial | $35,165.20 | ↑ +17% |
| Private Health Care Systems | PPO | $40,188.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Removal/replacement ppm generator dual lead system at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,816.40 | $447.93 – $10,775.64 |
| UPMC Carlisle | Carlisle | $19,161.00 | $542.62 – $27,144.75 |
| UPMC Cole | Coudersport | $7,452.00 | $294.11 – $3,477.60 |
| UPMC Community Osteopathic | Harrisburg | $19,161.00 | $542.62 – $27,144.75 |
| UPMC Hamot | Erie | $9,586.80 | $447.93 – $14,511.47 |
| UPMC Hanover | Hanover | $19,161.00 | $542.62 – $26,238.52 |
| UPMC Jameson | New Castle | $13,717.80 | $455.84 – $13,469.54 |
| UPMC Lititz | Lititz | $19,161.00 | $379.69 – $26,238.52 |