Incision of breast lesion at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$1,693.20
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.
$2,822.00
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.
$76.65 with Aetna vs $2,520.39 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 | $76.65 | ↓ -95% |
| Geisinger | Medicaid | $101.46 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $110.08 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $124.41 | ↓ -93% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $256.69 | ↓ -85% |
| UPMC Health Plan | Managed Medicare | $259.28 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $259.28 | ↓ -85% |
| Humana | Medicare | $261.87 | ↓ -85% |
| AmeriHealth Caritas | Medicaid | $265.76 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $265.76 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $268.54 | ↓ -84% |
| Cigna | Medicare | $272.24 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $280.02 | ↓ -83% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $280.02 | ↓ -83% |
| Aetna | Medicare | $282.43 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicaid | $370.40 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $423.98 | ↓ -75% |
| UPMC Health Plan | Commercial | $648.20 | ↓ -62% |
| Geisinger | Commercial | $694.50 | ↓ -59% |
| InterGroup | PPO | $740.80 | ↓ -56% |
| Humana | Commercial | $740.80 | ↓ -56% |
| Galaxy Health Plan | Commercial | $740.80 | ↓ -56% |
| Multiplan | Worker's Compensation | $740.80 | ↓ -56% |
| Multiplan | PPO/Auto | $740.80 | ↓ -56% |
| Aetna | Commercial | $759.32 | ↓ -55% |
| United Healthcare | Medicare | $790.16 | ↓ -53% |
| BCBS of Western NY | Medicare Advantage | $1,041.88 | ↓ -38% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,069.74 | ↑ +22% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,069.74 | ↑ +22% |
| UPMC Health Plan | CHIP | $2,298.80 | ↑ +36% |
| Highmark BCBS of PA | Managed Care | $2,520.39 | ↑ +49% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,520.39 | ↑ +49% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Incision of breast lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,765.20 | $73.00 – $2,353.60 |
| UPMC Bedford | Everett | $4,534.80 | $76.65 – $6,802.20 |
| UPMC Carlisle | Carlisle | $2,715.60 | $92.71 – $3,847.10 |
| UPMC Community Osteopathic | Harrisburg | $2,715.60 | $92.71 – $3,847.10 |
| UPMC East | Monroeville | $3,824.40 | $80.30 – $5,099.20 |
| UPMC Hamot | Erie | $3,013.20 | $80.30 – $2,246.66 |
| UPMC Hanover | Hanover | $2,742.00 | $92.71 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $3,508.20 | $80.30 – $1,668.28 |