Cystourethroscopy w/biopsy(s) 52204 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$379.20
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.
$632.00
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.
$129.68 with Aetna vs $2,299.02 with UPMC Health Plan — 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 | $129.68 | ↓ -66% |
| Geisinger | Medicaid | $171.65 | ↓ -55% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $175.19 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $176.96 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $176.96 | ↓ -53% |
| Humana | Medicare | $178.73 | ↓ -53% |
| AmeriHealth Caritas | Medicaid | $181.38 | ↓ -52% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $181.38 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $183.28 | ↓ -52% |
| Cigna | Medicare | $185.81 | ↓ -51% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $186.24 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $191.12 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $191.12 | ↓ -50% |
| Aetna | Medicare | $192.76 | ↓ -49% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $210.47 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicaid | $252.80 | ↓ -33% |
| UPMC Health Plan | Commercial | $442.40 | ↑ +17% |
| Geisinger | Commercial | $474.00 | ↑ +25% |
| InterGroup | PPO | $505.60 | ↑ +33% |
| Humana | Commercial | $505.60 | ↑ +33% |
| Galaxy Health Plan | Commercial | $505.60 | ↑ +33% |
| Multiplan | Worker's Compensation | $505.60 | ↑ +33% |
| Multiplan | PPO/Auto | $505.60 | ↑ +33% |
| Aetna | Commercial | $518.24 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $549.17 | ↑ +45% |
| BCBS of Western NY | Medicare Advantage | $1,041.88 | ↑ +175% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,654.65 | ↑ +336% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,654.65 | ↑ +336% |
| Highmark BCBS of PA | Managed Care | $2,014.92 | ↑ +431% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,014.92 | ↑ +431% |
| UPMC Health Plan | CHIP | $2,299.02 | ↑ +506% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
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Cystourethroscopy w/biopsy(s) 52204 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Northwest | Seneca | $4,869.60 | $135.85 – $2,050.66 |
| Uniontown Hospital | Uniontown | $2,459.50 | $135.85 – $4,208.25 |
| UPMC Altoona | Altoona | not published | $123.50 – $2,109.25 |
| UPMC Bedford | Everett | not published | $129.68 – $2,109.25 |
| UPMC Carlisle | Carlisle | not published | $156.84 – $3,135.44 |
| UPMC Community Osteopathic | Harrisburg | not published | $166.72 – $5,805.45 |
| UPMC East | Monroeville | not published | $135.85 – $2,148.31 |
| UPMC Hamot | Erie | not published | $135.85 – $2,840.52 |