healthcosts.net
Breast Biopsy (ultrasound-guided, percutaneous) at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$419.40
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.
$699.00
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.
$145.83 with Aetna vs $2,690.72 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $145.83 | ↓ -65% |
| Geisinger | Medicaid | $193.04 | ↓ -54% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $193.76 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $195.72 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $195.72 | ↓ -53% |
| Humana | Medicare | $197.68 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $200.61 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $200.61 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $202.71 | ↓ -52% |
| Cigna | Medicare | $205.51 | ↓ -51% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $209.45 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $211.38 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $211.38 | ↓ -50% |
| Aetna | Medicare | $213.19 | ↓ -49% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $236.70 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicaid | $279.60 | ↓ -33% |
| UPMC Health Plan | Commercial | $489.30 | ↑ +17% |
| Geisinger | Commercial | $524.25 | ↑ +25% |
| Galaxy Health Plan | Commercial | $559.20 | ↑ +33% |
| Humana | Commercial | $559.20 | ↑ +33% |
| InterGroup | PPO | $559.20 | ↑ +33% |
| Multiplan | PPO/Auto | $559.20 | ↑ +33% |
| Multiplan | Worker's Compensation | $559.20 | ↑ +33% |
| Aetna | Commercial | $573.18 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $893.20 | ↑ +113% |
| BCBS of Western NY | Medicare Advantage | $1,041.88 | ↑ +148% |
| UPMC Health Plan | CHIP | $2,146.82 | ↑ +412% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,209.62 | ↑ +427% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,209.62 | ↑ +427% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,690.72 | ↑ +542% |
| Highmark BCBS of PA | Managed Care | $2,690.72 | ↑ +542% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Breast Biopsy (ultrasound-guided, percutaneous) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $4,790.40 | $152.78 – $5,588.80 |
| UPMC Carlisle | Carlisle | $2,087.40 | $176.39 – $6,413.00 |
| UPMC Altoona | Altoona | $1,945.20 | $138.89 – $2,593.60 |
| UPMC Bedford | Everett | $2,637.00 | $145.83 – $3,955.50 |
| UPMC Community Osteopathic | Harrisburg | $2,087.40 | $187.50 – $2,957.15 |
| UPMC Hanover | Hanover | $2,087.40 | $176.39 – $3,026.73 |
| UPMC Horizon-Greenville | Greenville | $3,146.40 | $145.83 – $4,457.40 |
| UPMC Jameson | New Castle | $3,146.40 | $135.09 – $4,614.72 |