Rmvl icd gen w/rplc icd gen sgl lead sys at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$51,008.40
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.
$85,014.00
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.
$471.43 with Highmark BCBS of PA vs $68,011.20 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $471.43 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $540.55 | ↓ -99% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,049.66 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,364.48 | ↓ -97% |
| Highmark BCBS of PA | Managed Care | $1,405.76 | ↓ -97% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,827.42 | ↓ -96% |
| Highmark BCBS of PA | UPMC Emergent | $2,811.51 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $21,457.53 | ↓ -58% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $21,861.98 | ↓ -57% |
| United Healthcare | Unison Advantage Non Special Needs | $22,469.74 | ↓ -56% |
| Aetna of PA | Medicare | $22,469.74 | ↓ -56% |
| United Healthcare | Medicare | $22,897.73 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $23,109.59 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $23,111.73 | ↓ -55% |
| Cigna | Medicare | $23,111.73 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $23,111.73 | ↓ -55% |
| United Healthcare | Unison Advantage Special Needs | $23,539.72 | ↓ -54% |
| Aetna | Medicare | $23,539.72 | ↓ -54% |
| United Healthcare | Compass Exchange | $28,054.62 | ↓ -45% |
| UPMC Health Plan | CHIP | $29,828.34 | ↓ -42% |
| Aetna | Neighborhood Network | $29,839.91 | ↓ -42% |
| Aetna | EBR FI | $32,305.32 | ↓ -37% |
| Aetna | Home Depot Employer Group | $32,475.35 | ↓ -36% |
| Cigna | NBR ASO/FI | $33,155.46 | ↓ -35% |
| United Healthcare | All Business | $33,155.46 | ↓ -35% |
| Aetna | NBR ASO/FI | $33,155.46 | ↓ -35% |
| Cigna | New Business ASO | $33,155.46 | ↓ -35% |
| Aetna | EBR ASO | $34,005.60 | ↓ -33% |
| Cigna | Commercial | $34,005.60 | ↓ -33% |
| Cigna | EBR | $34,005.60 | ↓ -33% |
| UPMC Health Plan | Commercial | $41,699.37 | ↓ -18% |
| InterGroup | PPO | $42,507.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $46,757.70 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $46,757.70 | ↓ -8% |
| Coventry/First Health | Commercial | $59,509.80 | ↑ +17% |
| Private Health Care Systems | PPO | $68,011.20 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Rmvl icd gen w/rplc icd gen sgl lead sys at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $40,435.80 | $466.99 – $53,914.40 |
| UPMC Carlisle | Carlisle | $34,564.20 | $565.70 – $48,965.95 |
| UPMC Community Osteopathic | Harrisburg | $34,564.20 | $565.70 – $48,965.95 |
| UPMC Hamot | Erie | $32,186.40 | $466.99 – $31,124.41 |
| UPMC Hanover | Hanover | $34,564.20 | $565.70 – $34,308.56 |
| UPMC Lititz | Lititz | $34,564.20 | $565.70 – $34,493.87 |
| UPMC Memorial | York | $34,564.20 | $380.61 – $34,437.84 |
| UPMC Mercy | Pittsburgh | $36,067.20 | $466.99 – $23,539.72 |