Surgical pathology level 4 gross & microscopic examination at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$255.60
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.
$426.00
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.
$27.54 with UPMC Health Plan vs $340.80 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $27.54 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $33.42 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $34.00 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $37.40 | ↓ -85% |
| United Healthcare Community Plan for Families | Unison Kids | $39.10 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $47.26 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $50.42 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $51.08 | ↓ -80% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $52.04 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $53.08 | ↓ -79% |
| Aetna of PA | Medicare | $53.49 | ↓ -79% |
| United Healthcare | Unison Advantage Non Special Needs | $53.49 | ↓ -79% |
| United Healthcare | Medicare | $54.51 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicare | $55.01 | ↓ -78% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $55.02 | ↓ -78% |
| Cigna | Medicare | $55.02 | ↓ -78% |
| AmeriHealth Caritas | Medicare | $55.02 | ↓ -78% |
| United Healthcare | Unison Advantage Special Needs | $56.03 | ↓ -78% |
| Aetna | Medicare | $56.03 | ↓ -78% |
| PA Health & Wellness | PA Medicaid HMO | $57.94 | ↓ -77% |
| Highmark BCBS of PA | Managed Care - Social Mission | $58.10 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $77.81 | ↓ -70% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $96.73 | ↓ -62% |
| UPMC Health Plan | CHIP | $100.13 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Indemnity | $129.55 | ↓ -49% |
| United Healthcare | Compass Exchange | $140.58 | ↓ -45% |
| Aetna | Neighborhood Network | $149.53 | ↓ -41% |
| Highmark BCBS of PA | UPMC Emergent | $155.61 | ↓ -39% |
| Aetna | EBR FI | $161.88 | ↓ -37% |
| Aetna | Home Depot Employer Group | $162.73 | ↓ -36% |
| Cigna | New Business ASO | $166.14 | ↓ -35% |
| Aetna | NBR ASO/FI | $166.14 | ↓ -35% |
| Cigna | NBR ASO/FI | $166.14 | ↓ -35% |
| United Healthcare | All Business | $166.14 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $168.74 | ↓ -34% |
| Aetna | EBR ASO | $170.40 | ↓ -33% |
| Cigna | EBR | $170.40 | ↓ -33% |
| Cigna | Commercial | $170.40 | ↓ -33% |
| InterGroup | PPO | $213.00 | ↓ -17% |
| Coventry/First Health | Commercial | $298.20 | ↑ +17% |
| Private Health Care Systems | PPO | $340.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 4 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $197.40 | $9.00 – $263.20 |
| UPMC Bedford | Everett | $100.20 | $18.38 – $156.82 |
| UPMC Carlisle | Carlisle | $116.40 | $11.79 – $164.12 |
| UPMC Cole | Coudersport | $169.20 | $35.70 – $225.60 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $11.79 – $166.18 |
| UPMC Hamot | Erie | $250.20 | $33.11 – $168.74 |
| UPMC Northwest | Seneca | $169.20 | $27.80 – $158.79 |
| UPMC Hanover | Hanover | $116.40 | $11.79 – $166.18 |