Complx repair sal addl 5 cm/> 13122 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$486.60
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.
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What you pay up front if you don't use insurance.
$811.00
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.
$66.25 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 | $66.25 | ↓ -86% |
| UPMC Health Plan | Managed Medicare | $66.92 | ↓ -86% |
| AmeriHealth Caritas | Medicare | $66.92 | ↓ -86% |
| Humana | Medicare | $67.59 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $68.59 | ↓ -86% |
| AmeriHealth Caritas | Medicaid | $68.59 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $69.31 | ↓ -86% |
| Cigna | Medicare | $70.27 | ↓ -86% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $72.27 | ↓ -85% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $72.27 | ↓ -85% |
| Aetna | Medicare | $72.89 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $95.60 | ↓ -80% |
| Geisinger | Medicaid | $131.45 | ↓ -73% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $131.45 | ↓ -73% |
| UPMC Health Plan | Commercial | $167.30 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $176.83 | ↓ -64% |
| Geisinger | Commercial | $179.25 | ↓ -63% |
| InterGroup | PPO | $191.20 | ↓ -61% |
| Humana | Commercial | $191.20 | ↓ -61% |
| Galaxy Health Plan | Commercial | $191.20 | ↓ -61% |
| Multiplan | Worker's Compensation | $191.20 | ↓ -61% |
| Multiplan | PPO/Auto | $191.20 | ↓ -61% |
| Aetna | Commercial | $195.98 | ↓ -60% |
| United Healthcare | Medicare | $227.08 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $533.13 | ↑ +10% |
| Highmark BCBS of PA | Managed Care - Social Mission | $533.13 | ↑ +10% |
| Highmark BCBS of PA | Managed Care | $649.19 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity | $649.19 | ↑ +33% |
| UPMC Health Plan | CHIP | $1,308.89 | ↑ +169% |
| BCBS of Western NY | Medicare Advantage | $1,470.59 | ↑ +202% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Complx repair sal addl 5 cm/> 13122 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $418.20 | $176.83 – $1,308.89 |
| UPMC Carlisle | Carlisle | $828.60 | $95.43 – $1,173.85 |
| UPMC Community Osteopathic | Harrisburg | $828.60 | $95.43 – $1,308.89 |
| UPMC East | Monroeville | $1,062.00 | $176.83 – $1,416.00 |
| UPMC Hamot | Erie | $498.60 | $176.83 – $1,625.03 |
| UPMC Northwest | Seneca | $1,128.00 | $176.83 – $618.31 |
| UPMC Hanover | Hanover | $828.60 | $95.43 – $1,308.89 |
| UPMC Horizon-Greenville | Greenville | $872.40 | $176.83 – $710.02 |