Unlisted neurological dx px at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$96.00
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.
$160.00
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.
$18.77 with Highmark BCBS of PA vs $164.09 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.77 | ↓ -80% |
| UPMC Health Plan | CHIP | $48.05 | ↓ -50% |
| Highmark BCBS of PA | Managed Care - Social Mission | $49.02 | ↓ -49% |
| United Healthcare | Compass Exchange | $52.80 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $54.31 | ↓ -43% |
| Aetna | Neighborhood Network | $56.16 | ↓ -42% |
| UPMC Health Plan | Commercial | $58.31 | ↓ -39% |
| Aetna | EBR FI | $60.80 | ↓ -37% |
| Aetna | Home Depot Employer Group | $61.12 | ↓ -36% |
| Cigna | NBR ASO/FI | $62.40 | ↓ -35% |
| United Healthcare | All Business | $62.40 | ↓ -35% |
| Aetna | NBR ASO/FI | $62.40 | ↓ -35% |
| Cigna | New Business ASO | $62.40 | ↓ -35% |
| Cigna | EBR | $64.00 | ↓ -33% |
| Cigna | Commercial | $64.00 | ↓ -33% |
| Aetna | EBR ASO | $64.00 | ↓ -33% |
| Highmark BCBS of PA | Managed Care | $65.65 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Indemnity | $72.74 | ↓ -24% |
| InterGroup | PPO | $80.00 | ↓ -17% |
| PA Health & Wellness | PA Medicaid HMO | $88.00 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $88.00 | ↓ -8% |
| Coventry/First Health | Commercial | $112.00 | ↑ +17% |
| Private Health Care Systems | PPO | $128.00 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $131.29 | ↑ +37% |
| UPMC Health Plan | Managed Medicare | $149.57 | ↑ +56% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $152.39 | ↑ +59% |
| United Healthcare | Unison Advantage Non Special Needs | $156.63 | ↑ +63% |
| Aetna of PA | Medicare | $156.63 | ↑ +63% |
| United Healthcare | Medicare | $159.61 | ↑ +66% |
| Highmark Wholecare (prev Gateway) | Medicare | $161.09 | ↑ +68% |
| Cigna | Medicare | $161.10 | ↑ +68% |
| AmeriHealth Caritas | Medicare | $161.10 | ↑ +68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $161.10 | ↑ +68% |
| United Healthcare | Unison Advantage Special Needs | $164.09 | ↑ +71% |
| Aetna | Medicare | $164.09 | ↑ +71% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Unlisted neurological dx px at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Uniontown Hospital | Uniontown | $192.00 | $124.72 – $290.60 |