Remove in/ex hem groups 2+ at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
not published by hospital
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.
not published by hospital
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.
$369.60 with UPMC Health Plan vs $5,038.97 with Highmark BCBS of PA — 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 | $369.60 | — |
| United Healthcare Community Plan for Families | Unison Kids | $386.40 | — |
| Geisinger | Medicaid/CHIP | $467.01 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $498.29 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $506.69 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $524.53 | — |
| PA Health & Wellness | PA Medicaid HMO | $572.61 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $844.93 | — |
| UPMC Work Partners | Workers Comp | $1,514.50 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,881.27 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,445.51 | — |
| Highmark BCBS of PA | Managed Care | $2,519.49 | — |
| UPMC Health Plan | Managed Medicare | $2,621.60 | — |
| UPMC Health Plan | CHIP | $2,635.86 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $2,671.01 | — |
| Aetna of PA | Medicare | $2,745.27 | — |
| United Healthcare | Unison Advantage Non Special Needs | $2,745.27 | — |
| United Healthcare | Medicare | $2,797.56 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $2,823.44 | — |
| Cigna | Medicare | $2,823.70 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,823.70 | — |
| AmeriHealth Caritas | Medicare | $2,823.70 | — |
| Aetna | Medicare | $2,875.99 | — |
| United Healthcare | Unison Advantage Special Needs | $2,875.99 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $3,275.22 | — |
| Highmark BCBS of PA | UPMC Emergent | $5,038.97 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Remove in/ex hem groups 2+ at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $956.40 | $352.80 – $1,348.46 |
| Uniontown Hospital | Uniontown | $1,606.00 | $205.80 – $5,587.82 |
| UPMC Altoona | Altoona | not published | $336.00 – $2,823.70 |
| UPMC Bedford | Everett | not published | $352.80 – $2,823.70 |
| UPMC Carlisle | Carlisle | not published | $426.72 – $4,197.49 |
| UPMC Community Osteopathic | Harrisburg | not published | $453.60 – $7,348.95 |
| UPMC Hamot | Erie | not published | $369.60 – $3,802.67 |
| UPMC Northwest | Seneca | not published | $369.60 – $2,745.27 |