Special physics consult at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$646.80
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.
$1,078.00
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.
$106.15 with UPMC Health Plan vs $898.64 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $106.15 | ↓ -84% |
| United Healthcare Community Plan for Families | Unison Kids | $110.97 | ↓ -83% |
| UPMC Health Plan | Managed Medicare | $126.92 | ↓ -80% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $129.31 | ↓ -80% |
| Aetna of PA | Medicare | $132.91 | ↓ -79% |
| United Healthcare | Unison Advantage Non Special Needs | $132.91 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $134.13 | ↓ -79% |
| United Healthcare | Medicare | $135.44 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicare | $136.69 | ↓ -79% |
| Cigna | Medicare | $136.71 | ↓ -79% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $136.71 | ↓ -79% |
| AmeriHealth Caritas | Medicare | $136.71 | ↓ -79% |
| Aetna | Medicare | $139.24 | ↓ -78% |
| United Healthcare | Unison Advantage Special Needs | $139.24 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $143.11 | ↓ -78% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $145.52 | ↓ -78% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $150.65 | ↓ -77% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $150.68 | ↓ -77% |
| PA Health & Wellness | PA Medicaid HMO | $164.46 | ↓ -75% |
| UPMC Health Plan | Commercial | $225.24 | ↓ -65% |
| UPMC Work Partners | Workers Comp | $320.99 | ↓ -50% |
| Highmark BCBS of PA | Managed Care - Social Mission | $335.50 | ↓ -48% |
| United Healthcare | Compass Exchange | $355.74 | ↓ -45% |
| Aetna | Neighborhood Network | $378.38 | ↓ -41% |
| Aetna | EBR FI | $409.64 | ↓ -37% |
| Aetna | Home Depot Employer Group | $411.80 | ↓ -36% |
| United Healthcare | All Business | $420.42 | ↓ -35% |
| Aetna | NBR ASO/FI | $420.42 | ↓ -35% |
| Cigna | NBR ASO/FI | $420.42 | ↓ -35% |
| Cigna | New Business ASO | $420.42 | ↓ -35% |
| Cigna | EBR | $431.20 | ↓ -33% |
| Aetna | EBR ASO | $431.20 | ↓ -33% |
| Cigna | Commercial | $431.20 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $436.13 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $449.32 | ↓ -31% |
| UPMC Health Plan | CHIP | $480.42 | ↓ -26% |
| InterGroup | PPO | $539.00 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity | $584.09 | ↓ -10% |
| Coventry/First Health | Commercial | $754.60 | ↑ +17% |
| Private Health Care Systems | PPO | $862.40 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $898.64 | ↑ +39% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Special physics consult at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $561.60 | $96.50 – $748.80 |
| UPMC Carlisle | Carlisle | $892.20 | $122.56 – $1,263.95 |
| UPMC Community Osteopathic | Harrisburg | $892.20 | $122.56 – $1,263.95 |
| UPMC Hamot | Erie | $876.00 | $106.15 – $320.99 |
| UPMC Northwest | Seneca | $564.00 | $106.15 – $296.21 |
| UPMC Horizon-Greenville | Greenville | $456.60 | $106.15 – $296.21 |
| UPMC Lititz | Lititz | $892.20 | $122.56 – $304.98 |
| UPMC Magee | Pittsburgh | $1,201.20 | $106.15 – $320.99 |