Bx breast 1st lesion strtctc at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$421.80
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.
$703.00
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.
$155.72 with Aetna vs $2,692.93 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $155.72 | ↓ -63% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $194.87 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $196.84 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $196.84 | ↓ -53% |
| Humana | Medicare | $198.81 | ↓ -53% |
| AmeriHealth Caritas | Medicaid | $201.76 | ↓ -52% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $201.76 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $203.87 | ↓ -52% |
| Geisinger | Medicaid | $206.12 | ↓ -51% |
| Cigna | Medicare | $206.68 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $212.59 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $212.59 | ↓ -50% |
| Aetna | Medicare | $214.41 | ↓ -49% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $223.64 | ↓ -47% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $252.73 | ↓ -40% |
| Highmark Wholecare (prev Gateway) | Medicaid | $281.20 | ↓ -33% |
| UPMC Health Plan | Commercial | $492.10 | ↑ +17% |
| Geisinger | Commercial | $527.25 | ↑ +25% |
| InterGroup | PPO | $562.40 | ↑ +33% |
| Humana | Commercial | $562.40 | ↑ +33% |
| Galaxy Health Plan | Commercial | $562.40 | ↑ +33% |
| Multiplan | Worker's Compensation | $562.40 | ↑ +33% |
| Multiplan | PPO/Auto | $562.40 | ↑ +33% |
| Aetna | Commercial | $576.46 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $900.48 | ↑ +113% |
| BCBS of Western NY | Medicare Advantage | $1,041.88 | ↑ +147% |
| UPMC Health Plan | CHIP | $2,131.42 | ↑ +405% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,211.43 | ↑ +424% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,211.43 | ↑ +424% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,692.93 | ↑ +538% |
| Highmark BCBS of PA | Managed Care | $2,692.93 | ↑ +538% |
Visitor-reported prices
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Bx breast 1st lesion strtctc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,923.20 | $148.30 – $3,897.60 |
| UPMC Carlisle | Carlisle | $2,087.40 | $188.34 – $6,413.00 |
| UPMC Community Osteopathic | Harrisburg | $2,087.40 | $200.21 – $2,957.15 |
| UPMC Hamot | Erie | $7,023.60 | $163.13 – $900.48 |
| UPMC Northwest | Seneca | $5,112.00 | $163.13 – $1,621.93 |
| UPMC Hanover | Hanover | $2,087.40 | $188.34 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $4,273.80 | $155.72 – $919.85 |
| UPMC Jameson | New Castle | $4,273.80 | $143.14 – $900.48 |