Resp virus 6-11 targets at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$1,082.40
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.
$1,804.00
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.
$185.46 with UPMC Health Plan vs $1,443.20 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 | Commercial | $185.46 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $215.52 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $218.65 | ↓ -80% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $222.77 | ↓ -79% |
| Aetna of PA | Medicare | $228.96 | ↓ -79% |
| United Healthcare | Unison Advantage Non Special Needs | $228.96 | ↓ -79% |
| United Healthcare | Medicare | $233.32 | ↓ -78% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $234.70 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $235.48 | ↓ -78% |
| AmeriHealth Caritas | Medicare | $235.50 | ↓ -78% |
| Cigna | Medicare | $235.50 | ↓ -78% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $235.50 | ↓ -78% |
| Aetna | Medicare | $239.87 | ↓ -78% |
| United Healthcare | Unison Advantage Special Needs | $239.87 | ↓ -78% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $252.52 | ↓ -77% |
| UPMC Health Plan | Managed Medicaid | $258.17 | ↓ -76% |
| United Healthcare Community Plan for Families | Unison Kids | $269.90 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $326.21 | ↓ -70% |
| Highmark Wholecare (prev Gateway) | Medicaid | $348.06 | ↓ -68% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $366.39 | ↓ -66% |
| PA Health & Wellness | PA Medicaid HMO | $399.98 | ↓ -63% |
| Highmark BCBS of PA | Managed Care - Social Mission | $438.97 | ↓ -59% |
| Highmark BCBS of PA | Managed Care | $587.90 | ↓ -46% |
| United Healthcare | Compass Exchange | $595.32 | ↓ -45% |
| Aetna | Neighborhood Network | $633.20 | ↓ -42% |
| UPMC Health Plan | CHIP | $674.18 | ↓ -38% |
| Aetna | EBR FI | $685.52 | ↓ -37% |
| Aetna | Home Depot Employer Group | $689.13 | ↓ -36% |
| Aetna | NBR ASO/FI | $703.56 | ↓ -35% |
| United Healthcare | All Business | $703.56 | ↓ -35% |
| Cigna | New Business ASO | $703.56 | ↓ -35% |
| Cigna | NBR ASO/FI | $703.56 | ↓ -35% |
| Cigna | Commercial | $721.60 | ↓ -33% |
| Aetna | EBR ASO | $721.60 | ↓ -33% |
| Cigna | EBR | $721.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $730.88 | ↓ -32% |
| InterGroup | PPO | $902.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $978.85 | ↓ -10% |
| Highmark BCBS of PA | UPMC Emergent | $1,175.79 | ↑ +9% |
| Coventry/First Health | Commercial | $1,262.80 | ↑ +17% |
| Private Health Care Systems | PPO | $1,443.20 | ↑ +33% |
Visitor-reported prices
Comments
Resp virus 6-11 targets at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,237.80 | $215.52 – $1,650.40 |
| UPMC Bedford | Everett | $1,667.40 | $78.68 – $2,501.10 |
| UPMC Carlisle | Carlisle | $1,212.60 | $190.06 – $1,717.85 |
| UPMC Community Osteopathic | Harrisburg | $1,212.60 | $215.88 – $1,717.85 |
| UPMC Hamot | Erie | $1,335.60 | $215.52 – $326.21 |
| UPMC Northwest | Seneca | $1,575.00 | $187.18 – $269.90 |
| UPMC Hanover | Hanover | $1,212.60 | $190.06 – $348.90 |
| UPMC Horizon-Greenville | Greenville | $968.40 | $187.78 – $404.46 |