Bronchoscopy/lung bx each 31628 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$4,327.80
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.
$7,213.00
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.
$184.59 with United Healthcare Community Plan for Families vs $6,491.70 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 | $184.59 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $193.38 | ↓ -96% |
| United Healthcare Community Plan for Families | Unison Kids | $202.17 | ↓ -95% |
| Aetna | Medicaid | $219.75 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $244.34 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $260.71 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $265.11 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $274.44 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $299.60 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $760.44 | ↓ -82% |
| UPMC Health Plan | Commercial | $1,268.19 | ↓ -71% |
| Aetna of PA | Medicare | $1,268.23 | ↓ -71% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,023.84 | ↓ -53% |
| UPMC Health Plan | CHIP | $2,299.30 | ↓ -47% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,493.18 | ↓ -42% |
| Cigna | EBR | $2,885.20 | ↓ -33% |
| Aetna | EBR ASO | $2,885.20 | ↓ -33% |
| Cigna | Commercial | $2,885.20 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $3,031.39 | ↓ -30% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $3,515.06 | ↓ -19% |
| Aetna | EBR FI | $3,534.37 | ↓ -18% |
| Aetna | Medicare | $3,620.51 | ↓ -16% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,628.24 | ↓ -16% |
| United Healthcare | Medicare | $3,761.11 | ↓ -13% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,795.91 | ↓ -12% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,796.26 | ↓ -12% |
| Cigna | Medicare | $3,796.26 | ↓ -12% |
| AmeriHealth Caritas | Medicare | $3,796.26 | ↓ -12% |
| United Healthcare | Compass Exchange | $3,967.15 | ↓ -8% |
| Aetna | Neighborhood Network | $4,472.06 | ↑ +3% |
| Aetna | Home Depot Employer Group | $4,594.68 | ↑ +6% |
| Aetna | NBR ASO/FI | $4,688.45 | ↑ +8% |
| United Healthcare | All Business | $4,688.45 | ↑ +8% |
| InterGroup | PPO | $4,688.45 | ↑ +8% |
| Cigna | New Business ASO | $4,688.45 | ↑ +8% |
| Cigna | NBR ASO/FI | $4,688.45 | ↑ +8% |
| Coventry/First Health | Commercial | $5,049.10 | ↑ +17% |
| Preferred Healthcare System | PPO | $5,770.40 | ↑ +33% |
| Humana | Commercial | $6,491.70 | ↑ +50% |
| SelectCare | Commercial | $6,491.70 | ↑ +50% |
| Private Health Care Systems | PPO | $6,491.70 | ↑ +50% |
| Health Coalition Partners | Intergroup | $6,491.70 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bronchoscopy/lung bx each 31628 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,372.20 | $175.80 – $1,829.60 |
| UPMC Community Osteopathic | Harrisburg | $4,452.00 | $237.33 – $6,307.00 |
| UPMC Hamot | Erie | $4,871.40 | $193.38 – $5,112.40 |
| UPMC Hanover | Hanover | $4,452.00 | $223.27 – $5,635.42 |
| UPMC Jameson | New Castle | $3,435.00 | $193.38 – $4,745.33 |
| UPMC Magee | Pittsburgh | $5,634.60 | $193.38 – $3,796.26 |
| UPMC Memorial | York | $4,452.00 | $223.27 – $5,656.67 |
| UPMC Mercy | Pittsburgh | $1,829.40 | $193.38 – $3,866.57 |