Biopsy of rectum wall anal approach 45100 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$339.60
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.
?
What you pay up front if you don't use insurance.
$566.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$68.19 with Highmark BCBS of PA vs $1,731.07 with UPMC Health Plan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $68.19 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $68.88 | ↓ -80% |
| United Healthcare | Medicare | $68.88 | ↓ -80% |
| AmeriHealth Caritas | Medicare | $68.88 | ↓ -80% |
| Humana | Medicare | $69.57 | ↓ -80% |
| AmeriHealth Caritas | Medicaid | $70.60 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $70.60 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $71.34 | ↓ -79% |
| Cigna | Medicare | $72.32 | ↓ -79% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $74.39 | ↓ -78% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $74.39 | ↓ -78% |
| Aetna | Medicare | $75.03 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $98.40 | ↓ -71% |
| Aetna | CHIP/Medicaid | $158.03 | ↓ -53% |
| UPMC Health Plan | Commercial | $172.20 | ↓ -49% |
| Geisinger | Commercial | $184.50 | ↓ -46% |
| InterGroup | PPO | $196.80 | ↓ -42% |
| Humana | Commercial | $196.80 | ↓ -42% |
| Galaxy Health Plan | Commercial | $196.80 | ↓ -42% |
| Multiplan | Worker's Compensation | $196.80 | ↓ -42% |
| Multiplan | PPO/Auto | $196.80 | ↓ -42% |
| Aetna | Commercial | $201.72 | ↓ -41% |
| Geisinger | Medicaid | $209.18 | ↓ -38% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $226.95 | ↓ -33% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $256.48 | ↓ -24% |
| UPMC Work Partners | Workers Comp | $600.87 | ↑ +77% |
| BCBS of Western NY | Medicare Advantage | $771.51 | ↑ +127% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,341.93 | ↑ +295% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,341.93 | ↑ +295% |
| Highmark BCBS of PA | Managed Care | $1,634.11 | ↑ +381% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,634.11 | ↑ +381% |
| UPMC Health Plan | CHIP | $1,731.07 | ↑ +410% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of rectum wall anal approach 45100 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Uniontown Hospital | Uniontown | $3,190.50 | $165.55 – $5,587.82 |
| UPMC Altoona | Altoona | not published | $150.50 – $2,823.70 |
| UPMC Community Osteopathic | Harrisburg | not published | $203.18 – $7,348.95 |
| UPMC East | Monroeville | not published | $165.55 – $2,875.99 |
| UPMC Hamot | Erie | not published | $165.55 – $3,802.67 |
| UPMC Mercy | Pittsburgh | not published | $165.55 – $2,875.99 |
| UPMC Presbyterian | Pittsburgh | not published | $165.55 – $2,875.99 |