healthcosts.net
Blood Clotting (PT/INR) Test at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$30.00
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.
?
What you pay up front if you don't use insurance.
$50.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1.55 with Aetna of PA vs $45.00 with SelectCare — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 of PA | Medicare | $1.55 | ↓ -95% |
| UPMC Health Plan | Commercial | $3.62 | ↓ -88% |
| UPMC Health Plan | Managed Medicare | $3.70 | ↓ -88% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $4.00 | ↓ -87% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $4.20 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $4.24 | ↓ -86% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $4.29 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $4.40 | ↓ -85% |
| Aetna | Medicare | $4.42 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $4.43 | ↓ -85% |
| United Healthcare | Medicare | $4.59 | ↓ -85% |
| United Healthcare Community Plan for Families | Unison Kids | $4.60 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $4.63 | ↓ -85% |
| Cigna | Medicare | $4.63 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $4.63 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4.63 | ↓ -85% |
| Aetna | Medicaid | $5.00 | ↓ -83% |
| Geisinger | Medicaid/CHIP | $5.56 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $5.93 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $6.24 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $6.82 | ↓ -77% |
| UPMC Health Plan | CHIP | $12.99 | ↓ -57% |
| Cigna | EBR | $20.00 | ↓ -33% |
| Cigna | Commercial | $20.00 | ↓ -33% |
| Aetna | EBR ASO | $20.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $21.13 | ↓ -30% |
| Aetna | EBR FI | $24.50 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $26.04 | ↓ -13% |
| United Healthcare | Compass Exchange | $27.50 | ↓ -8% |
| Aetna | Neighborhood Network | $31.00 | ↑ +3% |
| Aetna | Home Depot Employer Group | $31.85 | ↑ +6% |
| Cigna | NBR ASO/FI | $32.50 | ↑ +8% |
| Aetna | NBR ASO/FI | $32.50 | ↑ +8% |
| Cigna | New Business ASO | $32.50 | ↑ +8% |
| United Healthcare | All Business | $32.50 | ↑ +8% |
| InterGroup | PPO | $32.50 | ↑ +8% |
| Coventry/First Health | Commercial | $35.00 | ↑ +17% |
| Preferred Healthcare System | PPO | $40.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $45.00 | ↑ +50% |
| Private Health Care Systems | PPO | $45.00 | ↑ +50% |
| Humana | Commercial | $45.00 | ↑ +50% |
| SelectCare | Commercial | $45.00 | ↑ +50% |
Visitor-reported prices
Comments
Blood Clotting (PT/INR) Test at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $58.80 | $3.57 – $78.40 |
| UPMC Passavant-McCandless | Pittsburgh | $96.00 | $3.61 – $90.10 |
| UPMC Hamot | Erie | $130.20 | $4.00 – $151.90 |
| UPMC Carlisle | Carlisle | $22.20 | $4.00 – $31.45 |
| UPMC Altoona | Altoona | $54.60 | $4.00 – $72.80 |
| UPMC Cole | Coudersport | $30.60 | $2.79 – $40.80 |
| UPMC Community Osteopathic | Harrisburg | $22.20 | $4.00 – $29.75 |
| UPMC Hanover | Hanover | $22.20 | $4.00 – $32.19 |