Tib/per revasc stent & ather 37231 at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$121,914.60
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.
$203,191.00
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.
$17,165.80 with UPMC Health Plan vs $162,552.80 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 | Managed Medicare | $17,165.80 | ↓ -86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $17,489.36 | ↓ -86% |
| Aetna of PA | Medicare | $17,975.56 | ↓ -85% |
| United Healthcare | Unison Advantage Non Special Needs | $17,975.56 | ↓ -85% |
| United Healthcare | Medicare | $18,317.95 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $18,487.43 | ↓ -85% |
| Cigna | Medicare | $18,489.15 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $18,489.15 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $18,489.15 | ↓ -85% |
| Aetna | Medicare | $18,831.54 | ↓ -85% |
| United Healthcare | Unison Advantage Special Needs | $18,831.54 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $19,708.47 | ↓ -84% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $24,236.22 | ↓ -80% |
| Highmark BCBS of PA | Managed Care - Social Mission | $53,962.88 | ↓ -56% |
| United Healthcare | Compass Exchange | $67,053.03 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $70,147.48 | ↓ -42% |
| UPMC Health Plan | CHIP | $71,116.85 | ↓ -42% |
| Aetna | Neighborhood Network | $71,320.04 | ↓ -42% |
| Highmark BCBS of PA | Managed Care | $72,269.52 | ↓ -41% |
| Aetna | EBR FI | $77,212.58 | ↓ -37% |
| Aetna | Home Depot Employer Group | $77,618.96 | ↓ -36% |
| Cigna | NBR ASO/FI | $79,244.49 | ↓ -35% |
| Cigna | New Business ASO | $79,244.49 | ↓ -35% |
| Aetna | NBR ASO/FI | $79,244.49 | ↓ -35% |
| United Healthcare | All Business | $79,244.49 | ↓ -35% |
| Aetna | EBR ASO | $81,276.40 | ↓ -33% |
| Cigna | Commercial | $81,276.40 | ↓ -33% |
| Cigna | EBR | $81,276.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity | $93,947.15 | ↓ -23% |
| UPMC Health Plan | Commercial | $99,665.19 | ↓ -18% |
| InterGroup | PPO | $101,595.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $111,755.05 | ↓ -8% |
| PA Health & Wellness | PA Medicaid HMO | $111,755.05 | ↓ -8% |
| Coventry/First Health | Commercial | $142,233.70 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $144,539.04 | ↑ +19% |
| Private Health Care Systems | PPO | $162,552.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Tib/per revasc stent & ather 37231 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $66,098.40 | $1,016.56 – $93,639.40 |
| UPMC Community Osteopathic | Harrisburg | $66,098.40 | $1,016.56 – $93,639.40 |
| UPMC Hamot | Erie | $50,165.40 | $19,708.47 – $24,899.21 |
| UPMC Hanover | Hanover | $66,098.40 | $1,016.56 – $27,446.48 |
| UPMC Lititz | Lititz | $66,098.40 | $1,016.56 – $27,594.74 |
| UPMC Memorial | York | $66,098.40 | $1,016.56 – $27,549.92 |
| UPMC Somerset | Somerset | $66,098.40 | $892.40 – $19,708.47 |