Surgical pathology level 5 gross & microscopic examination at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$379.20
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.
$632.00
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.
$35.92 with UPMC Health Plan vs $505.60 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 | $35.92 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $45.50 | ↓ -88% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $49.52 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $50.05 | ↓ -87% |
| United Healthcare Community Plan for Families | Unison Kids | $52.33 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $63.24 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $67.48 | ↓ -82% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $71.03 | ↓ -81% |
| PA Health & Wellness | PA Medicaid HMO | $77.54 | ↓ -80% |
| Highmark BCBS of PA | Managed Care - Social Mission | $86.08 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $115.29 | ↓ -70% |
| UPMC Health Plan | CHIP | $130.59 | ↓ -66% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $143.33 | ↓ -62% |
| Highmark BCBS of PA | Commercial - Indemnity | $191.96 | ↓ -49% |
| United Healthcare | Compass Exchange | $208.56 | ↓ -45% |
| Aetna | Neighborhood Network | $221.83 | ↓ -42% |
| Highmark BCBS of PA | UPMC Emergent | $230.58 | ↓ -39% |
| Aetna | EBR FI | $240.16 | ↓ -37% |
| Aetna | Home Depot Employer Group | $241.42 | ↓ -36% |
| Cigna | NBR ASO/FI | $246.48 | ↓ -35% |
| United Healthcare | All Business | $246.48 | ↓ -35% |
| Aetna | NBR ASO/FI | $246.48 | ↓ -35% |
| Cigna | New Business ASO | $246.48 | ↓ -35% |
| Aetna | EBR ASO | $252.80 | ↓ -33% |
| Cigna | EBR | $252.80 | ↓ -33% |
| Cigna | Commercial | $252.80 | ↓ -33% |
| UPMC Work Partners | Workers Comp | $269.87 | ↓ -29% |
| InterGroup | PPO | $316.00 | ↓ -17% |
| UPMC Health Plan | Managed Medicare | $343.88 | ↓ -9% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $350.36 | ↓ -8% |
| Aetna of PA | Medicare | $360.10 | ↓ -5% |
| United Healthcare | Unison Advantage Non Special Needs | $360.10 | ↓ -5% |
| United Healthcare | Medicare | $366.96 | ↓ -3% |
| Highmark Wholecare (prev Gateway) | Medicare | $370.35 | ↓ -2% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $370.39 | ↓ -2% |
| AmeriHealth Caritas | Medicare | $370.39 | ↓ -2% |
| Cigna | Medicare | $370.39 | ↓ -2% |
| Aetna | Medicare | $377.25 | ↓ -1% |
| United Healthcare | Unison Advantage Special Needs | $377.25 | ↓ -1% |
| Coventry/First Health | Commercial | $442.40 | ↑ +17% |
| Private Health Care Systems | PPO | $505.60 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $234.60 | $11.50 – $312.80 |
| UPMC Bedford | Everett | $189.60 | $36.42 – $284.40 |
| UPMC Carlisle | Carlisle | $664.80 | $15.06 – $941.80 |
| UPMC Cole | Coudersport | $572.40 | $47.77 – $763.20 |
| UPMC Community Osteopathic | Harrisburg | $664.80 | $15.06 – $378.62 |
| UPMC Hamot | Erie | $360.60 | $45.50 – $427.47 |
| UPMC Northwest | Seneca | $360.60 | $36.26 – $360.10 |
| UPMC Hanover | Hanover | $664.80 | $15.06 – $549.82 |