Surgical pathology level 6 gross & microscopic examination at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$516.00
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.
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What you pay up front if you don't use insurance.
$860.00
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.
$54.19 with UPMC Health Plan vs $856.70 with Aetna — 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 | $54.19 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $67.42 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $67.60 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $74.36 | ↓ -86% |
| United Healthcare Community Plan for Families | Unison Kids | $77.74 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $93.96 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $100.25 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $105.53 | ↓ -80% |
| PA Health & Wellness | PA Medicaid HMO | $115.20 | ↓ -78% |
| Highmark BCBS of PA | Managed Care - Social Mission | $117.20 | ↓ -77% |
| Highmark BCBS of PA | Managed Care | $156.97 | ↓ -70% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $195.14 | ↓ -62% |
| UPMC Health Plan | CHIP | $197.01 | ↓ -62% |
| Highmark BCBS of PA | Commercial - Indemnity | $261.35 | ↓ -49% |
| United Healthcare | Compass Exchange | $283.80 | ↓ -45% |
| Aetna | Neighborhood Network | $301.86 | ↓ -42% |
| Highmark BCBS of PA | UPMC Emergent | $313.93 | ↓ -39% |
| Aetna | EBR FI | $326.80 | ↓ -37% |
| Aetna | Home Depot Employer Group | $328.52 | ↓ -36% |
| Cigna | NBR ASO/FI | $335.40 | ↓ -35% |
| United Healthcare | All Business | $335.40 | ↓ -35% |
| Aetna | NBR ASO/FI | $335.40 | ↓ -35% |
| Cigna | New Business ASO | $335.40 | ↓ -35% |
| Aetna | EBR ASO | $344.00 | ↓ -33% |
| Cigna | EBR | $344.00 | ↓ -33% |
| Cigna | Commercial | $344.00 | ↓ -33% |
| UPMC Work Partners | Workers Comp | $389.27 | ↓ -25% |
| InterGroup | PPO | $430.00 | ↓ -17% |
| Coventry/First Health | Commercial | $602.00 | ↑ +17% |
| Private Health Care Systems | PPO | $688.00 | ↑ +33% |
| UPMC Health Plan | Managed Medicare | $780.92 | ↑ +51% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $795.64 | ↑ +54% |
| United Healthcare | Unison Advantage Non Special Needs | $817.76 | ↑ +58% |
| Aetna of PA | Medicare | $817.76 | ↑ +58% |
| United Healthcare | Medicare | $833.34 | ↑ +62% |
| Highmark Wholecare (prev Gateway) | Medicare | $841.05 | ↑ +63% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $841.13 | ↑ +63% |
| AmeriHealth Caritas | Medicare | $841.13 | ↑ +63% |
| Cigna | Medicare | $841.13 | ↑ +63% |
| United Healthcare | Unison Advantage Special Needs | $856.70 | ↑ +66% |
| Aetna | Medicare | $856.70 | ↑ +66% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 6 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $336.00 | $17.50 – $448.00 |
| UPMC Bedford | Everett | $273.00 | $54.94 – $409.50 |
| UPMC Carlisle | Carlisle | $1,472.40 | $22.93 – $2,085.90 |
| UPMC Cole | Coudersport | $811.20 | $53.00 – $1,081.60 |
| UPMC Community Osteopathic | Harrisburg | $1,472.40 | $22.93 – $2,085.90 |
| UPMC Hamot | Erie | $320.40 | $66.79 – $970.76 |
| UPMC Northwest | Seneca | $691.20 | $54.70 – $817.76 |
| UPMC Hanover | Hanover | $1,472.40 | $22.93 – $1,248.61 |