Lysis of labial adhesions at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$223.20
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.
$372.00
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.
$66.15 with Aetna vs $1,715.22 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 | $66.15 | ↓ -70% |
| Geisinger | Medicaid | $87.56 | ↓ -61% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $95.00 | ↓ -57% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $103.12 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $104.16 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $104.16 | ↓ -53% |
| Humana | Medicare | $105.20 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $106.76 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $106.76 | ↓ -52% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $107.36 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $107.88 | ↓ -52% |
| Cigna | Medicare | $109.37 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $112.49 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $112.49 | ↓ -50% |
| Aetna | Medicare | $113.46 | ↓ -49% |
| Highmark Wholecare (prev Gateway) | Medicaid | $148.80 | ↓ -33% |
| UPMC Health Plan | Commercial | $260.40 | ↑ +17% |
| Geisinger | Commercial | $279.00 | ↑ +25% |
| InterGroup | PPO | $297.60 | ↑ +33% |
| Humana | Commercial | $297.60 | ↑ +33% |
| Galaxy Health Plan | Commercial | $297.60 | ↑ +33% |
| Multiplan | Worker's Compensation | $297.60 | ↑ +33% |
| Multiplan | PPO/Auto | $297.60 | ↑ +33% |
| Aetna | Commercial | $305.04 | ↑ +37% |
| UPMC Work Partners | Workers Comp | $348.83 | ↑ +56% |
| BCBS of Western NY | Medicare Advantage | $771.51 | ↑ +246% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $813.34 | ↑ +264% |
| Highmark BCBS of PA | Managed Care - Social Mission | $813.34 | ↑ +264% |
| Highmark BCBS of PA | Commercial - Indemnity | $990.43 | ↑ +344% |
| Highmark BCBS of PA | Managed Care | $990.43 | ↑ +344% |
| UPMC Health Plan | CHIP | $1,715.22 | ↑ +668% |
Visitor-reported prices
Comments
Lysis of labial adhesions at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Magee | Pittsburgh | $2,389.20 | $69.30 – $3,273.80 |
| Uniontown Hospital | Uniontown | $3,720.50 | $69.30 – $6,516.82 |
| UPMC Community Osteopathic | Harrisburg | not published | $85.05 – $5,805.45 |
| UPMC East | Monroeville | not published | $69.30 – $3,334.43 |
| UPMC Hamot | Erie | not published | $69.30 – $4,408.81 |
| UPMC Hanover | Hanover | not published | $80.01 – $4,859.86 |
| UPMC Memorial | York | not published | $80.01 – $4,878.16 |