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Skin Biopsy 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.
$35.45 with UPMC Health Plan vs $604.18 with UPMC Health Plan — 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 | $35.45 | — |
| United Healthcare Community Plan for Families | Unison Kids | $37.06 | — |
| Geisinger | Medicaid/CHIP | $44.80 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $47.80 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $48.60 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $50.31 | — |
| PA Health & Wellness | PA Medicaid HMO | $54.93 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $59.37 | — |
| UPMC Work Partners | Workers Comp | $116.66 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $132.20 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $171.84 | — |
| Highmark BCBS of PA | Managed Care | $177.04 | — |
| UPMC Health Plan | Managed Medicare | $189.95 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $193.53 | — |
| Aetna of PA | Medicare | $198.91 | — |
| United Healthcare | Unison Advantage Non Special Needs | $198.91 | — |
| United Healthcare | Medicare | $202.70 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $204.58 | — |
| AmeriHealth Caritas | Medicare | $204.60 | — |
| Cigna | Medicare | $204.60 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $204.60 | — |
| Aetna | Medicare | $208.38 | — |
| United Healthcare | Unison Advantage Special Needs | $208.38 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $230.15 | — |
| UPMC Health Plan | Commercial | $345.15 | — |
| Highmark BCBS of PA | UPMC Emergent | $354.08 | — |
| UPMC Health Plan | CHIP | $604.18 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Skin Biopsy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $823.80 | $35.45 – $1,167.05 |
| UPMC Carlisle | Carlisle | $575.40 | $40.93 – $1,016.56 |
| UPMC Altoona | Altoona | $613.80 | $32.23 – $818.40 |
| UPMC Bedford | Everett | $381.60 | $33.84 – $572.40 |
| UPMC Cole | Coudersport | $357.60 | $31.88 – $2,094.25 |
| UPMC Hanover | Hanover | $575.40 | $40.93 – $1,016.56 |
| UPMC Horizon-Greenville | Greenville | $823.80 | $35.45 – $1,167.05 |
| UPMC Kane | Kane | $98.40 | $35.45 – $131.20 |