Bundled special stain group 1 microorganisms at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$49.80
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.
$83.00
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.
$8.23 with UPMC Health Plan vs $125.55 with PA Health & Wellness — 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $8.23 | ↓ -83% |
| Aetna of PA | Medicare | $18.38 | ↓ -63% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $22.01 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $27.11 | ↓ -46% |
| UPMC Health Plan | CHIP | $29.51 | ↓ -41% |
| Cigna | Commercial | $33.20 | ↓ -33% |
| Cigna | EBR | $33.20 | ↓ -33% |
| Aetna | EBR ASO | $33.20 | ↓ -33% |
| Aetna | EBR FI | $40.67 | ↓ -18% |
| UPMC Health Plan | Managed Medicare | $43.93 | ↓ -12% |
| United Healthcare | Compass Exchange | $45.65 | ↓ -8% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $50.94 | ↑ +2% |
| Aetna | Neighborhood Network | $51.46 | ↑ +3% |
| Aetna | Medicare | $52.47 | ↑ +5% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $52.58 | ↑ +6% |
| Aetna | Home Depot Employer Group | $52.87 | ↑ +6% |
| InterGroup | PPO | $53.95 | ↑ +8% |
| United Healthcare | All Business | $53.95 | ↑ +8% |
| Aetna | NBR ASO/FI | $53.95 | ↑ +8% |
| Cigna | New Business ASO | $53.95 | ↑ +8% |
| Cigna | NBR ASO/FI | $53.95 | ↑ +8% |
| United Healthcare | Medicare | $54.51 | ↑ +9% |
| Highmark Wholecare (prev Gateway) | Medicare | $55.01 | ↑ +10% |
| AmeriHealth Caritas | Medicare | $55.02 | ↑ +10% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $55.02 | ↑ +10% |
| Cigna | Medicare | $55.02 | ↑ +10% |
| Coventry/First Health | Commercial | $58.10 | ↑ +17% |
| UPMC Work Partners | Workers Comp | $60.54 | ↑ +22% |
| Preferred Healthcare System | PPO | $66.40 | ↑ +33% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $73.67 | ↑ +48% |
| Humana | Commercial | $74.70 | ↑ +50% |
| SelectCare | Commercial | $74.70 | ↑ +50% |
| Health Coalition Partners | Intergroup | $74.70 | ↑ +50% |
| Private Health Care Systems | PPO | $74.70 | ↑ +50% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $77.35 | ↑ +55% |
| UPMC Health Plan | Managed Medicaid | $81.04 | ↑ +63% |
| United Healthcare Community Plan for Families | Unison Kids | $84.72 | ↑ +70% |
| Aetna | Medicaid | $92.09 | ↑ +85% |
| Geisinger | Medicaid/CHIP | $102.39 | ↑ +106% |
| Highmark Wholecare (prev Gateway) | Medicaid | $109.25 | ↑ +119% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $115.01 | ↑ +131% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $125.55 | ↑ +152% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Bundled special stain group 1 microorganisms at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $174.60 | $7.94 – $232.80 |
| UPMC Carlisle | Carlisle | $116.40 | $26.58 – $164.90 |
| UPMC Cole | Coudersport | $220.80 | $29.51 – $294.40 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $29.51 – $164.90 |
| UPMC East | Monroeville | $61.20 | $8.01 – $102.39 |
| UPMC Hamot | Erie | $207.00 | $7.94 – $102.39 |
| UPMC Northwest | Seneca | $67.20 | $8.19 – $84.72 |
| UPMC Hanover | Hanover | $116.40 | $29.51 – $100.34 |