healthcosts.net
Avul nail plate addl at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$622.20
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.
$1,037.00
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.
$27.04 with United Healthcare Community Plan for Families vs $933.30 with Health Coalition Partners — 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | Unison MedPLUS | $27.04 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $28.32 | ↓ -95% |
| United Healthcare Community Plan for Families | Unison Kids | $29.61 | ↓ -95% |
| Aetna | Medicaid | $32.19 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $35.79 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $38.19 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $38.83 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $40.20 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $43.88 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $58.03 | ↓ -91% |
| UPMC Health Plan | Commercial | $156.13 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $257.74 | ↓ -59% |
| Aetna | Medicare | $259.25 | ↓ -58% |
| UPMC Health Plan | CHIP | $283.08 | ↓ -55% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $317.50 | ↓ -49% |
| Cigna | Commercial | $414.80 | ↓ -33% |
| Aetna | EBR ASO | $414.80 | ↓ -33% |
| Cigna | EBR | $414.80 | ↓ -33% |
| Aetna | EBR FI | $508.13 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $518.50 | ↓ -17% |
| United Healthcare | Compass Exchange | $570.35 | ↓ -8% |
| Aetna | Neighborhood Network | $642.94 | ↑ +3% |
| Aetna | Home Depot Employer Group | $660.57 | ↑ +6% |
| InterGroup | PPO | $674.05 | ↑ +8% |
| Cigna | NBR ASO/FI | $674.05 | ↑ +8% |
| Aetna | NBR ASO/FI | $674.05 | ↑ +8% |
| United Healthcare | All Business | $674.05 | ↑ +8% |
| Cigna | New Business ASO | $674.05 | ↑ +8% |
| Coventry/First Health | Commercial | $725.90 | ↑ +17% |
| Preferred Healthcare System | PPO | $829.60 | ↑ +33% |
| SelectCare | Commercial | $933.30 | ↑ +50% |
| Private Health Care Systems | PPO | $933.30 | ↑ +50% |
| Humana | Commercial | $933.30 | ↑ +50% |
| Health Coalition Partners | Intergroup | $933.30 | ↑ +50% |
Visitor-reported prices
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Avul nail plate addl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $370.80 | $32.70 – $525.30 |
| UPMC Northwest | Seneca | $571.80 | $28.32 – $810.05 |
| UPMC Mercy | Pittsburgh | $388.20 | $28.32 – $582.30 |
| UPMC Muncy | Muncy | $114.00 | $28.32 – $152.00 |
| UPMC Passavant-McCandless | Pittsburgh | $357.00 | $28.32 – $505.75 |
| UPMC Presbyterian | Pittsburgh | $456.60 | $28.32 – $646.85 |
| UPMC Somerset | Somerset | $370.80 | $28.32 – $463.50 |
| UPMC Wellsboro | Wellsboro | $31.20 | $5.04 – $58.03 |