Otolaryngo binocular microscopy 92504 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$28.20
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.
$47.00
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.
$7.48 with Highmark BCBS of PA vs $168.00 with United Healthcare — 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 | $7.48 | ↓ -73% |
| UPMC Health Plan | Managed Medicare | $7.56 | ↓ -73% |
| AmeriHealth Caritas | Medicare | $7.56 | ↓ -73% |
| United Healthcare | Medicare | $7.56 | ↓ -73% |
| Humana | Medicare | $7.64 | ↓ -73% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $7.75 | ↓ -73% |
| AmeriHealth Caritas | Medicaid | $7.75 | ↓ -73% |
| UPMC Health Plan | Managed Medicaid | $7.83 | ↓ -72% |
| Cigna | Medicare | $7.94 | ↓ -72% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $8.16 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $8.16 | ↓ -71% |
| Aetna | Medicare | $8.23 | ↓ -71% |
| BCBS of Western NY | Medicare Advantage | $9.65 | ↓ -66% |
| Highmark Wholecare (prev Gateway) | Medicaid | $10.80 | ↓ -62% |
| Geisinger | Medicaid | $14.85 | ↓ -47% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $14.85 | ↓ -47% |
| UPMC Health Plan | Commercial | $18.90 | ↓ -33% |
| Geisinger | Commercial | $20.25 | ↓ -28% |
| InterGroup | PPO | $21.60 | ↓ -23% |
| Humana | Commercial | $21.60 | ↓ -23% |
| Multiplan | Worker's Compensation | $21.60 | ↓ -23% |
| Multiplan | PPO/Auto | $21.60 | ↓ -23% |
| Galaxy Health Plan | Commercial | $21.60 | ↓ -23% |
| Aetna | Commercial | $22.14 | ↓ -21% |
| UPMC Work Partners | Workers Comp | $38.15 | ↑ +35% |
| Highmark BCBS of PA | Managed Care - Social Mission | $122.97 | ↑ +336% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $122.97 | ↑ +336% |
| Highmark BCBS of PA | Managed Care | $149.73 | ↑ +431% |
| Highmark BCBS of PA | Commercial - Indemnity | $149.73 | ↑ +431% |
| United Healthcare | Commercial | $168.00 | ↑ +496% |