Cell function assay w/stim at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$913.20
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.
$1,522.00
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.
$49.02 with Aetna of PA vs $1,369.80 with Humana — 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 |
|---|---|---|---|
| Aetna of PA | Medicare | $49.02 | ↓ -95% |
| UPMC Health Plan | Commercial | $67.76 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $77.84 | ↓ -91% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $81.73 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $85.62 | ↓ -91% |
| United Healthcare Community Plan for Families | Unison Kids | $89.52 | ↓ -90% |
| Aetna | Medicaid | $97.30 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $108.19 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $115.44 | ↓ -87% |
| UPMC Health Plan | Managed Medicare | $117.17 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $121.52 | ↓ -87% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $132.65 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $134.27 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $135.86 | ↓ -85% |
| Aetna | Medicare | $139.94 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $140.23 | ↓ -85% |
| United Healthcare | Medicare | $145.37 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $146.72 | ↓ -84% |
| AmeriHealth Caritas | Medicare | $146.73 | ↓ -84% |
| Cigna | Medicare | $146.73 | ↓ -84% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $146.73 | ↓ -84% |
| UPMC Health Plan | CHIP | $242.98 | ↓ -73% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $501.55 | ↓ -45% |
| Cigna | EBR | $608.80 | ↓ -33% |
| Aetna | EBR ASO | $608.80 | ↓ -33% |
| Cigna | Commercial | $608.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $617.86 | ↓ -32% |
| Aetna | EBR FI | $745.78 | ↓ -18% |
| United Healthcare | Compass Exchange | $837.10 | ↓ -8% |
| Aetna | Neighborhood Network | $943.64 | ↑ +3% |
| Aetna | Home Depot Employer Group | $969.51 | ↑ +6% |
| Cigna | NBR ASO/FI | $989.30 | ↑ +8% |
| Aetna | NBR ASO/FI | $989.30 | ↑ +8% |
| United Healthcare | All Business | $989.30 | ↑ +8% |
| InterGroup | PPO | $989.30 | ↑ +8% |
| Cigna | New Business ASO | $989.30 | ↑ +8% |
| Coventry/First Health | Commercial | $1,065.40 | ↑ +17% |
| Preferred Healthcare System | PPO | $1,217.60 | ↑ +33% |
| Health Coalition Partners | Intergroup | $1,369.80 | ↑ +50% |
| SelectCare | Commercial | $1,369.80 | ↑ +50% |
| Private Health Care Systems | PPO | $1,369.80 | ↑ +50% |
| Humana | Commercial | $1,369.80 | ↑ +50% |
Visitor-reported prices
Comments
Cell function assay w/stim at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $898.80 | $77.84 – $1,198.40 |
| UPMC Carlisle | Carlisle | $490.20 | $12.47 – $694.45 |
| UPMC Community Osteopathic | Harrisburg | $490.20 | $77.84 – $694.45 |
| UPMC East | Monroeville | $717.60 | $66.84 – $956.80 |
| UPMC Hamot | Erie | $1,008.00 | $77.84 – $180.86 |
| UPMC Northwest | Seneca | $1,146.00 | $67.46 – $142.65 |
| UPMC Hanover | Hanover | $490.20 | $12.47 – $217.38 |
| UPMC Horizon-Greenville | Greenville | $721.80 | $67.68 – $254.94 |