Whfo nontorsion joint prefab at UPMC East
2775 Mosside Boulevard, Monroeville, PA · UPMC · · NPI 1225323983
$201.60
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.
$336.00
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.
$16.72 with Health Partners Plans (Jefferson Health Plan) vs $2,082.35 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $16.72 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $19.36 | ↓ -90% |
| Aetna | Medicare | $22.00 | ↓ -89% |
| United Healthcare | Compass Exchange | $29.04 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $29.04 | ↓ -86% |
| Aetna | Neighborhood Network | $30.89 | ↓ -85% |
| Aetna | EBR FI | $33.44 | ↓ -83% |
| Aetna | Home Depot Employer Group | $33.62 | ↓ -83% |
| Cigna | New Business ASO | $34.32 | ↓ -83% |
| Cigna | NBR ASO/FI | $34.32 | ↓ -83% |
| Aetna | NBR ASO/FI | $34.32 | ↓ -83% |
| United Healthcare | All Business | $34.32 | ↓ -83% |
| Aetna | EBR ASO | $35.20 | ↓ -83% |
| Cigna | EBR | $35.20 | ↓ -83% |
| Cigna | Commercial | $35.20 | ↓ -83% |
| InterGroup | PPO | $44.00 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $44.00 | ↓ -78% |
| PA Health & Wellness | PA Medicaid HMO | $48.40 | ↓ -76% |
| Coventry/First Health | Commercial | $61.60 | ↓ -69% |
| Private Health Care Systems | PPO | $70.40 | ↓ -65% |
| UPMC Work Partners | Workers Comp | $233.39 | ↑ +16% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $269.99 | ↑ +34% |
| Highmark BCBS of PA | Managed Care - Social Mission | $777.46 | ↑ +286% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $781.44 | ↑ +288% |
| UPMC Health Plan | CHIP | $804.83 | ↑ +299% |
| UPMC Health Plan | Commercial | $976.66 | ↑ +384% |
| Highmark BCBS of PA | Managed Care | $1,041.17 | ↑ +416% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,046.57 | ↑ +419% |
| Highmark BCBS of PA | UPMC Emergent | $2,082.35 | ↑ +933% |
Visitor-reported prices
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Whfo nontorsion joint prefab at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $159.00 | $50.35 – $804.83 |
| UPMC Bedford | Everett | $585.60 | $180.12 – $853.20 |
| UPMC Cole | Coudersport | $670.80 | $212.42 – $894.40 |
| UPMC Hamot | Erie | $537.00 | $233.39 – $267.44 |
| UPMC Northwest | Seneca | $547.20 | $233.39 – $973.92 |
| UPMC Horizon-Greenville | Greenville | $339.60 | $233.39 – $804.83 |
| UPMC Jameson | New Castle | $106.20 | $96.81 – $804.83 |
| UPMC Magee | Pittsburgh | $165.60 | $106.49 – $804.83 |