Complx repair enel addl 5cm/< 13153 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$715.80
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.
$1,193.00
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.
$96.47 with Highmark BCBS of PA vs $1,470.59 with BCBS of Western NY — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $96.47 | ↓ -87% |
| UPMC Health Plan | Managed Medicare | $97.44 | ↓ -86% |
| AmeriHealth Caritas | Medicare | $97.44 | ↓ -86% |
| Humana | Medicare | $98.41 | ↓ -86% |
| AmeriHealth Caritas | Medicaid | $99.88 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $99.88 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $100.92 | ↓ -86% |
| Cigna | Medicare | $102.31 | ↓ -86% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $105.24 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $105.24 | ↓ -85% |
| Aetna | Medicare | $106.14 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $139.20 | ↓ -81% |
| Geisinger | Medicaid | $191.40 | ↓ -73% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $191.40 | ↓ -73% |
| UPMC Health Plan | Commercial | $243.60 | ↓ -66% |
| Geisinger | Commercial | $261.00 | ↓ -64% |
| InterGroup | PPO | $278.40 | ↓ -61% |
| Humana | Commercial | $278.40 | ↓ -61% |
| Galaxy Health Plan | Commercial | $278.40 | ↓ -61% |
| Multiplan | Worker's Compensation | $278.40 | ↓ -61% |
| Multiplan | PPO/Auto | $278.40 | ↓ -61% |
| Aetna | Commercial | $285.36 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $287.80 | ↓ -60% |
| United Healthcare | Medicare | $334.04 | ↓ -53% |
| Highmark BCBS of PA | Managed Care - Social Mission | $778.60 | ↑ +9% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $778.60 | ↑ +9% |
| UPMC Health Plan | CHIP | $787.58 | ↑ +10% |
| Highmark BCBS of PA | Managed Care | $948.10 | ↑ +32% |
| Highmark BCBS of PA | Commercial - Indemnity | $948.10 | ↑ +32% |
| BCBS of Western NY | Medicare Advantage | $1,470.59 | ↑ +105% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Complx repair enel addl 5cm/< 13153 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,975.20 | $287.80 – $2,633.60 |
| UPMC Carlisle | Carlisle | $319.20 | $72.88 – $452.20 |
| UPMC Community Osteopathic | Harrisburg | $319.20 | $106.40 – $1,264.71 |
| UPMC Hamot | Erie | $654.00 | $287.80 – $977.81 |
| UPMC Hanover | Hanover | $319.20 | $155.20 – $787.58 |
| UPMC Jameson | New Castle | $483.60 | $118.28 – $787.58 |
| UPMC Lititz | Lititz | $319.20 | $118.28 – $787.58 |
| UPMC Magee | Pittsburgh | $1,500.60 | $130.11 – $487.63 |