Tongue biopsy; posterior one-third 41105 at UPMC Cole
1001 East Second Street, Coudersport, PA · UPMC · · NPI 110485184
$205.20
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.
$342.00
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.
$30.21 with Highmark BCBS of PA vs $2,299.30 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 |
|---|---|---|---|
| Highmark BCBS of PA | Community Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $30.21 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $30.52 | ↓ -85% |
| UPMC Health Plan | Managed Medicare | $30.52 | ↓ -85% |
| United Healthcare | Medicare | $30.52 | ↓ -85% |
| Humana | Medicare | $30.83 | ↓ -85% |
| AmeriHealth Caritas | Medicaid | $31.28 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC) | $31.28 | ↓ -85% |
| UPMC Health Plan | Managed Medicaid | $31.61 | ↓ -85% |
| Cigna | Medicare | $32.05 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP | $32.96 | ↓ -84% |
| PA Health & Wellness | Medicare Advantage (Allwell by Wellcare) | $32.96 | ↓ -84% |
| Aetna | Medicare | $33.24 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicaid | $43.60 | ↓ -79% |
| UPMC Health Plan | Commercial | $76.30 | ↓ -63% |
| Geisinger | Commercial | $81.75 | ↓ -60% |
| Aetna | CHIP/Medicaid | $84.00 | ↓ -59% |
| InterGroup | PPO | $87.20 | ↓ -58% |
| Galaxy Health Plan | Commercial | $87.20 | ↓ -58% |
| Multiplan | Worker's Compensation | $87.20 | ↓ -58% |
| Humana | Commercial | $87.20 | ↓ -58% |
| Multiplan | PPO/Auto | $87.20 | ↓ -58% |
| Geisinger | Medicaid | $111.19 | ↓ -46% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $120.64 | ↓ -41% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $136.34 | ↓ -34% |
| UPMC Work Partners | Workers Comp | $227.67 | ↑ +11% |
| Aetna | Commercial | $280.44 | ↑ +37% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $826.78 | ↑ +303% |
| Highmark BCBS of PA | Managed Care - Social Mission | $826.78 | ↑ +303% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,006.80 | ↑ +391% |
| Highmark BCBS of PA | Managed Care | $1,006.80 | ↑ +391% |
| BCBS of Western NY | Medicare Advantage | $1,041.88 | ↑ +408% |
| UPMC Health Plan | CHIP | $2,299.30 | ↑ +1021% |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Tongue biopsy; posterior one-third 41105 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | not published | $88.00 – $4,496.91 |
| UPMC Somerset | Somerset | not published | $88.00 – $3,091.88 |