healthcosts.net
Shoulder MRI (with and without contrast) at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$1,855.20
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.
$3,092.00
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.
$467.77 with BCBS of Western NY vs $2,473.60 with Multiplan — 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 |
|---|---|---|---|
| BCBS of Western NY | Medicare Advantage | $467.77 | ↓ -75% |
| Aetna | Commercial | $800.75 | ↓ -57% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $857.10 | ↓ -54% |
| AmeriHealth Caritas | Medicare | $865.76 | ↓ -53% |
| UPMC Health Plan | Managed Medicare | $865.76 | ↓ -53% |
| United Healthcare | Medicare | $865.76 | ↓ -53% |
| Humana | Medicare | $874.42 | ↓ -53% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $887.40 | ↓ -52% |
| AmeriHealth Caritas | Medicaid | $887.40 | ↓ -52% |
| UPMC Health Plan | Managed Medicaid | $896.68 | ↓ -52% |
| Cigna | Medicare | $909.05 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $935.02 | ↓ -50% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $935.02 | ↓ -50% |
| Aetna | Medicare | $943.06 | ↓ -49% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1,236.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,637.40 | ↓ -12% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,637.40 | ↓ -12% |
| Geisinger | Medicaid | $1,700.60 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,700.60 | ↓ -8% |
| United Healthcare | Commercial | $1,977.00 | ↑ +7% |
| UPMC Work Partners | Workers Comp | $1,992.24 | ↑ +7% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,993.87 | ↑ +7% |
| Highmark BCBS of PA | Managed Care | $1,993.87 | ↑ +7% |
| UPMC Health Plan | Commercial | $2,164.40 | ↑ +17% |
| UPMC Health Plan | CHIP | $2,267.27 | ↑ +22% |
| Geisinger | Commercial | $2,319.00 | ↑ +25% |
| Galaxy Health Plan | Commercial | $2,473.60 | ↑ +33% |
| Humana | Commercial | $2,473.60 | ↑ +33% |
| InterGroup | PPO | $2,473.60 | ↑ +33% |
| Multiplan | PPO/Auto | $2,473.60 | ↑ +33% |
| Multiplan | Worker's Compensation | $2,473.60 | ↑ +33% |
Visitor-reported prices
Comments
Shoulder MRI (with and without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,999.40 | $316.41 – $8,499.15 |
| UPMC East | Monroeville | $6,218.40 | $341.40 – $8,291.20 |
| UPMC Hamot | Erie | $2,415.00 | $265.23 – $2,817.50 |
| UPMC Jameson | New Castle | $3,830.40 | $340.48 – $5,617.92 |
| UPMC Altoona | Altoona | $2,604.00 | $425.00 – $3,472.00 |
| UPMC Carlisle | Carlisle | $2,713.80 | $618.88 – $3,844.55 |
| UPMC Bedford | Everett | $2,563.20 | $122.85 – $3,844.80 |
| UPMC Community Osteopathic | Harrisburg | $2,713.80 | $618.88 – $4,391.77 |