Sirolimus, oral at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$72.00
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.
?
What you pay up front if you don't use insurance.
$90.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$0.55 with UPMC Health Plan vs $94.22 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $0.55 | ↓ -99% |
| Geisinger | Medicaid/CHIP | $0.87 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $0.87 | ↓ -99% |
| PA Health & Wellness | PA Medicaid HMO | $0.87 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $0.87 | ↓ -99% |
| United Healthcare | Compass Exchange | $1.06 | ↓ -99% |
| United Healthcare | All Business | $1.06 | ↓ -99% |
| UPMC Health Plan | Commercial | $1.07 | ↓ -99% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1.43 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $1.51 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison Kids | $1.65 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $2.75 | ↓ -96% |
| UPMC Health Plan | CHIP | $3.10 | ↓ -96% |
| Aetna | Medicare | $5.75 | ↓ -92% |
| Aetna | Neighborhood Network | $8.07 | ↓ -89% |
| Aetna | EBR FI | $8.74 | ↓ -88% |
| Aetna | Home Depot Employer Group | $8.79 | ↓ -88% |
| Aetna | NBR ASO/FI | $8.97 | ↓ -88% |
| Cigna | New Business ASO | $8.97 | ↓ -88% |
| Cigna | NBR ASO/FI | $8.97 | ↓ -88% |
| Aetna | EBR ASO | $9.20 | ↓ -87% |
| Cigna | Commercial | $9.20 | ↓ -87% |
| Cigna | EBR | $9.20 | ↓ -87% |
| InterGroup | PPO | $11.50 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $11.50 | ↓ -84% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $12.22 | ↓ -83% |
| Coventry/First Health | Commercial | $16.10 | ↓ -78% |
| Private Health Care Systems | PPO | $18.40 | ↓ -74% |
| Highmark BCBS of PA | Managed Care - Social Mission | $35.18 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $35.36 | ↓ -51% |
| Highmark BCBS of PA | Managed Care | $47.11 | ↓ -35% |
| Highmark BCBS of PA | Commercial - Indemnity | $47.35 | ↓ -34% |
| Highmark BCBS of PA | UPMC Emergent | $94.22 | ↑ +31% |
Visitor-reported prices
Comments
Sirolimus, oral at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $20.40 | $0.55 – $3.76 |
| UPMC Community Osteopathic | Harrisburg | $20.40 | $0.80 – $20.15 |
| UPMC Hamot | Erie | $61.20 | $0.55 – $12.10 |
| UPMC Hanover | Hanover | $20.40 | $0.87 – $3.76 |
| UPMC Lititz | Lititz | $20.40 | $0.87 – $3.76 |
| UPMC Magee | Pittsburgh | $300.00 | $0.55 – $12.22 |
| UPMC Memorial | York | $20.40 | $0.87 – $9.86 |
| UPMC Mercy | Pittsburgh | $63.00 | $0.55 – $12.10 |