Excision of gum lesion 41825 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$207.60
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.
$346.00
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.
$95.91 with Highmark BCBS of PA vs $2,325.85 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 | $95.91 | ↓ -54% |
| UPMC Health Plan | Managed Medicare | $96.88 | ↓ -53% |
| AmeriHealth Caritas | Medicare | $96.88 | ↓ -53% |
| Humana | Medicare | $97.85 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $99.30 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $99.30 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $100.34 | ↓ -52% |
| Cigna | Medicare | $101.72 | ↓ -51% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $104.63 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $104.63 | ↓ -50% |
| Aetna | Medicare | $105.53 | ↓ -49% |
| Aetna | CHIP/Medicaid | $116.12 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicaid | $138.40 | ↓ -33% |
| Geisinger | Medicaid | $153.71 | ↓ -26% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $166.77 | ↓ -20% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $188.47 | ↓ -9% |
| UPMC Health Plan | Commercial | $242.20 | ↑ +17% |
| Geisinger | Commercial | $259.50 | ↑ +25% |
| InterGroup | PPO | $276.80 | ↑ +33% |
| Humana | Commercial | $276.80 | ↑ +33% |
| Galaxy Health Plan | Commercial | $276.80 | ↑ +33% |
| Multiplan | Worker's Compensation | $276.80 | ↑ +33% |
| Multiplan | PPO/Auto | $276.80 | ↑ +33% |
| Aetna | Commercial | $283.72 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $345.34 | ↑ +66% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $968.38 | ↑ +366% |
| Highmark BCBS of PA | Managed Care - Social Mission | $968.38 | ↑ +366% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,179.23 | ↑ +468% |
| Highmark BCBS of PA | Managed Care | $1,179.23 | ↑ +468% |
| UPMC Health Plan | CHIP | $1,713.94 | ↑ +726% |
| BCBS of Western NY | Medicare Advantage | $2,325.85 | ↑ +1020% |
Visitor-reported prices
Comments
Excision of gum lesion 41825 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $4,553.40 | $121.65 – $3,401.07 |
| Uniontown Hospital | Uniontown | $4,103.00 | $121.65 – $6,674.52 |
| UPMC Somerset | Somerset | not published | $121.65 – $3,091.88 |
| UPMC Williamsport | Williamsport | not published | $121.65 – $3,308.31 |