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Screening Colonoscopy (high risk) 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.
$792.58 with Highmark BCBS of PA vs $4,726.74 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $792.58 | — |
| UPMC Health Plan | Managed Medicare | $871.56 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $887.98 | — |
| Aetna of PA | Medicare | $912.67 | — |
| United Healthcare | Unison Advantage Non Special Needs | $912.67 | — |
| United Healthcare | Medicare | $930.05 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | — |
| AmeriHealth Caritas | Medicare | $938.75 | — |
| Cigna | Medicare | $938.75 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | — |
| Aetna | Medicare | $956.13 | — |
| United Healthcare | Unison Advantage Special Needs | $956.13 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,764.70 | — |
| UPMC Health Plan | CHIP | $2,241.85 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,293.98 | — |
| Highmark BCBS of PA | Managed Care | $2,363.37 | — |
| UPMC Health Plan | Commercial | $2,720.48 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $3,072.28 | — |
| Highmark BCBS of PA | UPMC Emergent | $4,726.74 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Screening Colonoscopy (high risk) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,800.00 | $792.58 – $2,550.00 |
| UPMC Bedford | Everett | $1,500.00 | $313.61 – $2,250.00 |
| UPMC Cole | Coudersport | $718.20 | $331.81 – $1,041.88 |
| UPMC Magee | Pittsburgh | $1,500.00 | $450.00 – $2,300.00 |
| UPMC McKeesport | Mckeesport | $1,500.00 | $792.58 – $2,125.00 |
| UPMC Muncy | Muncy | $1,575.00 | $393.75 – $2,362.50 |
| UPMC Presbyterian | Pittsburgh | $1,500.00 | $450.00 – $3,624.67 |
| UPMC Wellsboro | Wellsboro | $2,000.00 | $450.00 – $2,250.00 |