Kit lead specify 5-6-5 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$18,036.00
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.
$30,060.00
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.
$5,711.40 with Health Partners Plans (Jefferson Health Plan) vs $24,649.20 with Aetna — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $5,711.40 | ↓ -68% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $8,332.63 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $8,416.80 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $8,416.80 | ↓ -53% |
| United Healthcare | Medicare | $8,416.80 | ↓ -53% |
| Humana | Medicare | $8,500.97 | ↓ -53% |
| AmeriHealth Caritas | Medicaid | $8,627.22 | ↓ -52% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $8,627.22 | ↓ -52% |
| Cigna | Medicare | $8,837.64 | ↓ -51% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $9,090.14 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $9,090.14 | ↓ -50% |
| Aetna | Medicare | $9,168.30 | ↓ -49% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $9,919.80 | ↓ -45% |
| Geisinger | Medicaid | $9,919.80 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicaid | $10,821.60 | ↓ -40% |
| UPMC Health Plan | CHIP | $13,170.92 | ↓ -27% |
| United Healthcare | Commercial | $16,533.00 | ↓ -8% |
| UPMC Health Plan | Managed Medicaid | $18,637.20 | ↑ +3% |
| UPMC Health Plan | Commercial | $21,042.00 | ↑ +17% |
| Geisinger | Commercial | $22,545.00 | ↑ +25% |
| Galaxy Health Plan | Commercial | $24,048.00 | ↑ +33% |
| InterGroup | PPO | $24,048.00 | ↑ +33% |
| Humana | Commercial | $24,048.00 | ↑ +33% |
| Multiplan | Worker's Compensation | $24,048.00 | ↑ +33% |
| Multiplan | PPO/Auto | $24,048.00 | ↑ +33% |
| Aetna | Commercial | $24,649.20 | ↑ +37% |
| BCBS of Western NY | Medicare Advantage | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Kit lead specify 5-6-5 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $25,039.80 | $37.62 – $13,170.92 |
| UPMC Bedford | Everett | $7,272.00 | $38.00 – $13,170.92 |
| UPMC East | Monroeville | $21,221.40 | $133.00 – $13,170.92 |
| UPMC Hamot | Erie | $24,616.20 | $2,153.59 – $2,153.59 |
| UPMC Northwest | Seneca | $7,816.20 | $5,589.39 – $15,937.99 |
| UPMC Horizon-Greenville | Greenville | $11,638.80 | $5,488.59 – $13,170.92 |
| UPMC Jameson | New Castle | $7,176.60 | $582.60 – $13,170.92 |
| UPMC Kane | Kane | $2,910.60 | $9,698.74 – $9,698.74 |