▸ Hospital · PA · CCN 390328
UPMC East
2775 MOSSIDE BLVD, MONROEVILLE, PA, 15146
136 bedsAcute Care Hospitals4
Compliance grade
A
100/100
Procedures tracked
163
of 209 target codes
Payers
14
with negotiated rates
Rates published
41,311
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 7 | — | — | $9,377.79 | $11,532 | $25,070 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 12 | $434 | $260.4 | $51.6 | $169.26 | $427.09 |
| ED visit level 2 | CPT | 99282 | 13 | $1,088 | $652.8 | $36.28 | $369.92 | $870.4 |
| ED visit level 3 | CPT | 99283 | 13 | $1,467 | $880.2 | $62.31 | $498.78 | $1,173.6 |
| ED visit level 4 | CPT | 99284 | 13 | $1,867 | $1,120.2 | $104.86 | $634.78 | $1,493.6 |
| ED visit level 5 | CPT | 99285 | 13 | $2,285 | $1,371 | $152.61 | $776.9 | $1,828 |
| Critical care, first hour | CPT | 99291 | 13 | $2,503 | $1,501.8 | $166.79 | $883.66 | $2,002.4 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 13 | $3,105 | $1,863 | $101.65 | $1,055.7 | $2,484 |
| CT head with contrast | CPT | 70460 | 13 | $4,862 | $2,917.2 | $147.4 | $1,653.08 | $3,889.6 |
| CT head with and without contrast | CPT | 70470 | 13 | $5,404 | $3,242.4 | $170.18 | $1,837.36 | $4,323.2 |
| CT neck with contrast | CPT | 70491 | 13 | $4,862 | $2,917.2 | $151.25 | $1,653.08 | $3,889.6 |
| MRI brain without contrast | CPT | 70551 | 14 | $6,568 | $3,940.8 | $231.07 | $2,226.49 | $5,254.4 |
| MRI brain with contrast | CPT | 70552 | 14 | $8,457 | $5,074.2 | $341.4 | $2,833.1 | $6,765.6 |
| MRI brain with and without contrast | CPT | 70553 | 14 | $10,364 | $6,218.4 | $341.4 | $3,684.4 | $8,291.2 |
| Chest X-ray single view | CPT | 71045 | 13 | $727 | $436.2 | $6.49 | $239.91 | $581.6 |
| Chest X-ray 2 views | CPT | 71046 | 13 | $727 | $436.2 | $11.9 | $239.91 | $581.6 |
| Chest X-ray 3 views | CPT | 71047 | 13 | $727 | $436.2 | $15.12 | $239.91 | $581.6 |
| CT chest without contrast | CPT | 71250 | 13 | $3,105 | $1,863 | $101.65 | $1,089.86 | $2,484 |
| CT chest with contrast | CPT | 71260 | 13 | $4,862 | $2,917.2 | $159.66 | $1,653.08 | $3,889.6 |
| CT chest with and without contrast | CPT | 71270 | 13 | $5,404 | $3,242.4 | $170.18 | $1,837.36 | $4,323.2 |
| MRI chest without contrast | CPT | 71550 | 14 | $6,568 | $3,940.8 | $231.07 | $2,241.94 | $5,254.4 |
| MRI chest with and without contrast | CPT | 71552 | 14 | $10,364 | $6,218.4 | $341.4 | $3,580.76 | $8,291.2 |
| Lumbosacral spine X-ray | CPT | 72100 | 13 | $727 | $436.2 | $33.98 | $247.18 | $581.6 |
| CT cervical spine without contrast | CPT | 72125 | 13 | $3,105 | $1,863 | $101.65 | $1,089.86 | $2,484 |
| CT thoracic spine without contrast | CPT | 72128 | 13 | $3,105 | $1,863 | $101.65 | $1,089.86 | $2,484 |
| CT lumbar spine without contrast | CPT | 72131 | 13 | $3,105 | $1,863 | $101.65 | $1,089.86 | $2,484 |
| MRI cervical spine without contrast | CPT | 72141 | 14 | $6,568 | $3,940.8 | $231.07 | $2,241.94 | $5,254.4 |
| MRI thoracic spine without contrast | CPT | 72146 | 14 | $6,568 | $3,940.8 | $231.07 | $2,269.25 | $5,254.4 |
| MRI lumbar spine without contrast | CPT | 72148 | 14 | $6,568 | $3,940.8 | $231.07 | $2,269.25 | $5,254.4 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 14 | $8,457 | $5,074.2 | $341.4 | $2,833.1 | $6,765.6 |
| MRI cervical spine with and without contrast | CPT | 72156 | 14 | $10,364 | $6,218.4 | $341.4 | $3,694.3 | $8,291.2 |
| MRI lumbar spine with contrast | CPT | 72158 | 14 | $10,364 | $6,218.4 | $341.4 | $3,684.4 | $8,291.2 |
| CT pelvis without contrast | CPT | 72192 | 13 | $3,105 | $1,863 | $101.65 | $1,089.86 | $2,484 |
| CT pelvis with contrast | CPT | 72193 | 13 | $4,862 | $2,917.2 | $154.1 | $1,653.08 | $3,889.6 |
| Shoulder X-ray | CPT | 73030 | 12 | $727 | $436.2 | $28.33 | $276.26 | $581.6 |
| Humerus X-ray | CPT | 73060 | 12 | $727 | $436.2 | $27.76 | $276.26 | $581.6 |
| Hand X-ray 3 views | CPT | 73130 | 12 | $727 | $436.2 | $26.53 | $276.26 | $581.6 |
| MRI upper extremity joint without contrast | CPT | 73221 | 13 | $6,568 | $3,940.8 | $231.07 | $2,495.84 | $5,254.4 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 13 | $10,364 | $6,218.4 | $341.4 | $3,938.32 | $8,291.2 |
| Knee X-ray 1-2 views | CPT | 73560 | 12 | $727 | $436.2 | $29.9 | $276.26 | $581.6 |
| Ankle X-ray 3 views | CPT | 73610 | 12 | $727 | $436.2 | $26.02 | $276.26 | $581.6 |
| MRI lower extremity joint without contrast | CPT | 73721 | 13 | $6,568 | $3,940.8 | $231.07 | $2,495.84 | $5,254.4 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 13 | $10,364 | $6,218.4 | $341.4 | $3,938.32 | $8,291.2 |
| CT abdomen without contrast | CPT | 74150 | 13 | $3,105 | $1,863 | $101.65 | $1,089.86 | $2,484 |
| CT abdomen with contrast | CPT | 74160 | 13 | $4,862 | $2,917.2 | $163.96 | $1,653.08 | $3,889.6 |
| CT abdomen with and without contrast | CPT | 74170 | 13 | $5,404 | $3,242.4 | $170.18 | $1,837.36 | $4,323.2 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 13 | $6,551 | $3,930.6 | $185.12 | $2,299.4 | $5,240.8 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 13 | $9,388 | $5,632.8 | $289.48 | $3,295.19 | $7,510.4 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 13 | $9,388 | $5,632.8 | $341.4 | $3,295.19 | $7,510.4 |
| MRI abdomen without contrast | CPT | 74181 | 14 | $6,568 | $3,940.8 | $231.07 | $2,241.94 | $5,254.4 |
| MRI abdomen with and without contrast | CPT | 74183 | 14 | $10,364 | $6,218.4 | $341.4 | $3,580.76 | $8,291.2 |
| Abdominal ultrasound complete | CPT | 76700 | 13 | $2,060 | $1,236 | $101.65 | $700.4 | $1,648 |
| Abdominal ultrasound limited | CPT | 76705 | 13 | $1,495 | $897 | $68.75 | $508.3 | $1,196 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 13 | $2,001 | $1,200.6 | $89.65 | $680.34 | $1,600.8 |
| Obstetric ultrasound first trimester | CPT | 76801 | 13 | $2,175 | $1,305 | $92.5 | $739.5 | $1,740 |
| Transvaginal ultrasound | CPT | 76830 | 13 | $1,670 | $1,002 | $84.15 | $567.8 | $1,336 |
| Pelvic ultrasound complete | CPT | 76856 | 13 | $1,670 | $1,002 | $84.15 | $567.8 | $1,336 |
| Scrotal ultrasound | CPT | 76870 | 13 | $1,610 | $966 | $81.4 | $547.4 | $1,288 |
| Diagnostic mammography unilateral | CPT | 77065 | 12 | $561 | $336.6 | $58.27 | $218.79 | $448.8 |
| EKG tracing only | CPT | 93005 | 13 | $143 | $85.8 | $11.51 | $57.2 | $117.38 |
| Transthoracic echocardiogram complete | CPT | 93306 | 13 | $2,932 | $1,759.2 | $155.12 | $1,067.59 | $2,402.77 |
| Transthoracic echocardiogram | CPT | 93307 | 13 | $1,500 | $900 | $154.42 | $570 | $1,303.07 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 8 | — | — | $10,293 | $16,603 | $65,547 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 8 | — | — | $7,812.28 | $8,593.51 | $41,177 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 8 | — | — | $5,395.88 | $5,935.47 | $32,167 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $10,293 | $12,980 | $50,514 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $8,534.45 | $9,387.9 | $34,081 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $6,571.82 | $7,229 | $30,112 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $5,081.51 | $5,589.66 | $24,043 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $6,296.76 | $6,926.44 | $28,525 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $4,981.41 | $5,479.55 | $21,429 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $10,293 | $13,314 | $51,168 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $7,136.07 | $7,849.68 | $35,295 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $5,682.84 | $6,251.12 | $31,840 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $9,840.16 | $10,726 | $39,543 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $6,616.33 | $7,277.96 | $26,984 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $4,518.02 | $4,969.82 | $24,137 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $9,248.46 | $10,173 | $36,695 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $5,776.25 | $6,353.88 | $23,110 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $4,518.76 | $4,970.64 | $18,067 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $7,592.79 | $8,352.07 | $35,948 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $4,995.52 | $5,495.07 | $25,350 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $6,101.74 | $6,711.91 | $24,230 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 7 | — | — | $11,945 | $13,140 | $71,336 |
| Kidney/UTI w MCC | MS-DRG | 689 | 7 | — | — | $8,924.45 | $9,816.9 | $42,578 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | — | — | $6,323.43 | $6,955.77 | $23,296 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 7 | — | — | $14,724 | $16,196 | $65,454 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 7 | — | — | $7,908.65 | $8,699.51 | $33,427 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 13 | $292 | $175.2 | $8.36 | $99.28 | $233.6 |
| Electrolyte panel | CPT | 80051 | 13 | $231 | $138.6 | $6.92 | $78.54 | $184.8 |
| Comprehensive metabolic panel | CPT | 80053 | 13 | $360 | $216 | $10.43 | $122.4 | $288 |
| Lipid panel | CPT | 80061 | 13 | $354 | $212.4 | $13.24 | $120.36 | $283.2 |
| Renal function panel | CPT | 80069 | 13 | $298 | $178.8 | $8.58 | $101.32 | $238.4 |
| Hepatic function panel | CPT | 80076 | 13 | $280 | $168 | $8.08 | $95.2 | $224 |
| Urinalysis non-automated | CPT | 81002 | 13 | $89 | $53.4 | $3.44 | $30.26 | $71.2 |
| Urinalysis automated | CPT | 81003 | 13 | $78 | $46.8 | $2.22 | $17.6 | $62.4 |
| Glucose quantitative | CPT | 82947 | 13 | $98 | $58.8 | $3.89 | $33.32 | $78.4 |
| Hemoglobin A1c | CPT | 83036 | 13 | $264 | $158.4 | $7 | $89.76 | $211.2 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 13 | $419 | $251.4 | $16.6 | $142.46 | $335.2 |
| Complete blood count with automated differential | CPT | 85025 | 13 | $193 | $115.8 | $6 | $65.62 | $154.4 |
| Complete blood count without differential | CPT | 85027 | 13 | $161 | $96.6 | $6.39 | $54.74 | $128.8 |
| Urine culture bacterial | CPT | 87086 | 13 | $197 | $118.2 | $7.98 | $66.98 | $157.6 |
| Tissue exam by pathologist level IV | CPT | 88305 | 13 | $426 | $255.6 | $27.54 | $149.53 | $340.8 |
| maternity | ||||||||
| Vaginal delivery only | CPT | 59409 | 12 | $10,275 | $6,165 | $635.25 | $4,007.25 | $8,863.05 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 13 | $426 | $255.6 | $36.08 | $166.14 | $365.15 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 13 | $550 | $330 | $36.08 | $214.5 | $470.51 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 13 | $709 | $425.4 | $36.08 | $276.51 | $585.14 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 13 | $860 | $516 | $36.08 | $335.4 | $695.27 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 13 | $231 | $138.6 | $28.6 | $90.09 | $215.79 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 13 | $311 | $186.6 | $36.08 | $121.29 | $278.02 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 13 | $360 | $216 | $36.08 | $140.4 | $334.76 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 13 | $423 | $253.8 | $36.08 | $164.97 | $389.03 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 13 | $3,802 | $2,281.2 | $137.74 | $1,452.36 | $3,281.43 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 13 | $5,092 | $3,055.2 | $163.44 | $1,945.14 | $4,393.81 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 13 | $997 | $598.2 | $58.47 | $398.8 | $2,014.38 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 13 | $3,802 | $2,281.2 | $70.04 | $1,452.36 | $3,281.43 |
| Colonoscopy diagnostic | CPT | 45378 | 13 | $2,500 | $1,500 | $198.55 | $975 | $4,393.81 |
| Colonoscopy with biopsy | CPT | 45380 | 13 | $5,092 | $3,055.2 | $247.96 | $1,945.14 | $4,393.81 |
| Colonoscopy with polyp removal | CPT | 45385 | 13 | $5,092 | $3,055.2 | $294.89 | $1,945.14 | $4,393.81 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 8 | — | — | $2,642.84 | $17,746 | $19,286 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $10,293 | $10,293 | $10,293 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $10,293 | $10,293 | $10,293 |
| Total hip replacement | CPT | 27130 | 8 | — | — | $2,492.82 | $12,880 | $19,880 |
| Total knee replacement | CPT | 27447 | 8 | — | — | $2,690.84 | $13,003 | $19,880 |
| Knee revision arthroplasty single component | CPT | 27486 | 2 | — | — | $2,437.29 | $7,054.31 | $14,535 |
| Knee revision arthroplasty all components | CPT | 27487 | 2 | — | — | $3,120.49 | $9,031.71 | $18,610 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 3 | — | — | $844.93 | $2,490.83 | $5,038.97 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 8 | — | — | $1,274.16 | $7,151.22 | $7,598.8 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | — | — | $597.85 | $3,131.83 | $6,206.98 |
| ACL reconstruction | CPT | 29888 | 8 | — | — | $844.93 | $6,957.8 | $7,491.76 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $10,293 | $37,498 | $134,456 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $10,293 | $19,724 | $82,681 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $10,293 | $13,951 | $62,139 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $10,293 | $14,022 | $59,571 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $10,293 | $11,388 | $49,534 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $10,293 | $27,886 | $156,025 |
| Laparoscopic appendectomy | CPT | 44970 | 8 | — | — | $1,067.82 | $5,840.48 | $9,822.12 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $10,293 | $10,293 | $10,293 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $10,293 | $10,293 | $10,293 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $10,293 | $24,864 | $103,690 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $10,293 | $15,939 | $56,303 |
| Laparoscopic cholecystectomy | CPT | 47562 | 8 | — | — | $1,414.39 | $5,840.48 | $9,822.12 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 8 | — | — | $1,521.52 | $5,840.48 | $9,822.12 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $10,293 | $23,887 | $119,003 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $10,293 | $17,278 | $83,475 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $10,293 | $13,532 | $60,458 |
| Lap inguinal hernia repair | CPT | 49650 | 8 | — | — | $818.32 | $5,840.48 | $6,206.98 |
| Vaginal hysterectomy | CPT | 58260 | 8 | — | — | $1,446.27 | $4,988.69 | $8,625.24 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 8 | — | — | $1,761.78 | $6,007.35 | $14,191 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 8 | — | — | $1,582.65 | $10,422 | $10,918 |
| Lap salpingo-oophorectomy | CPT | 58661 | 8 | — | — | $1,244.42 | $5,840.48 | $7,421.42 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 7 | — | — | $21,730 | $23,903 | $102,149 |
| OR procedure for obesity w CC | MS-DRG | 620 | 7 | — | — | $12,187 | $13,405 | $59,618 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 7 | — | — | $11,505 | $12,656 | $48,133 |
| Complex cataract surgery | CPT | 66982 | 8 | — | — | $1,458.06 | $2,348.35 | $8,695.52 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | — | $662.78 | $2,337.37 | $8,695.52 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 7 | — | — | $9,520.56 | $10,473 | $40,757 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 7 | — | — | $15,514 | $17,066 | $47,573 |
| PCI single major coronary artery | CPT | 92920 | 11 | $26,353 | $15,812 | $773.91 | $10,278 | $21,082 |
| PCI with drug-eluting stent | CPT | 92928 | 11 | $40,020 | $24,012 | $859.73 | $15,688 | $32,016 |
| PCI bypass graft | CPT | 92937 | 11 | $40,020 | $24,012 | $517.93 | $15,688 | $32,016 |
| Coronary angiography with cath | CPT | 93455 | 12 | $11,019 | $6,611.4 | $1,289.74 | $4,297.41 | $9,023.83 |
| Coronary angiography with bypass cath | CPT | 93458 | 12 | $11,292 | $6,775.2 | $1,321.51 | $4,403.88 | $9,246.11 |
Payer mix (top 14)
| Payer | Codes covered | Median rate |
|---|---|---|
| Blue Cross Blue Shield | 159 | $1,292.83 |
| upmc health plan | 157 | $372.9 |
| Aetna | 156 | $850.43 |
| Cigna | 156 | $914 |
| pa health & wellness | 156 | $285.23 |
| UnitedHealthcare | 156 | $531.3 |
| amerihealth caritas | 153 | $248.89 |
| upmc work partners | 151 | $1,000.12 |
| geisinger | 99 | $192.63 |
| intergroup | 97 | $1,196.25 |
| private health care systems | 97 | $1,914 |
| First Health | 97 | $1,674.75 |
| health partners plans (jefferson health plan) | 83 | $176.06 |
| premier comp solutions | 17 | $1,376.17 |