Clsd tx fx radius/ulna dist w/manip 25605 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$1,863.00
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.
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What you pay up front if you don't use insurance.
$3,105.00
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.
$174.30 with United Healthcare Community Plan for Families vs $2,859.26 with Highmark BCBS of PA — 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 | $174.30 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $182.60 | ↓ -90% |
| United Healthcare Community Plan for Families | Unison Kids | $190.90 | ↓ -90% |
| Aetna | Medicaid | $207.50 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $230.72 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $246.18 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $250.33 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $259.14 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $282.90 | ↓ -85% |
| Aetna of PA | Medicare | $550.51 | ↓ -70% |
| UPMC Work Partners | Workers Comp | $972.10 | ↓ -48% |
| Aetna | EBR ASO | $1,242.00 | ↓ -33% |
| Cigna | Commercial | $1,242.00 | ↓ -33% |
| Cigna | EBR | $1,242.00 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $1,315.85 | ↓ -29% |
| UPMC Health Plan | Commercial | $1,464.66 | ↓ -21% |
| Aetna | EBR FI | $1,521.45 | ↓ -18% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,525.80 | ↓ -18% |
| Aetna | Medicare | $1,571.57 | ↓ -16% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,574.93 | ↓ -15% |
| United Healthcare | Medicare | $1,632.61 | ↓ -12% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,647.71 | ↓ -12% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,647.86 | ↓ -12% |
| Cigna | Medicare | $1,647.86 | ↓ -12% |
| AmeriHealth Caritas | Medicare | $1,647.86 | ↓ -12% |
| United Healthcare | Compass Exchange | $1,707.75 | ↓ -8% |
| Aetna | Neighborhood Network | $1,925.10 | ↑ +3% |
| Aetna | Home Depot Employer Group | $1,977.88 | ↑ +6% |
| Aetna | NBR ASO/FI | $2,018.25 | ↑ +8% |
| United Healthcare | All Business | $2,018.25 | ↑ +8% |
| InterGroup | PPO | $2,018.25 | ↑ +8% |
| Cigna | New Business ASO | $2,018.25 | ↑ +8% |
| Cigna | NBR ASO/FI | $2,018.25 | ↑ +8% |
| Coventry/First Health | Commercial | $2,173.50 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,321.01 | ↑ +25% |
| Preferred Healthcare System | PPO | $2,484.00 | ↑ +33% |
| UPMC Health Plan | CHIP | $2,655.52 | ↑ +43% |
| SelectCare | Commercial | $2,794.50 | ↑ +50% |
| Private Health Care Systems | PPO | $2,794.50 | ↑ +50% |
| Health Coalition Partners | Intergroup | $2,794.50 | ↑ +50% |
| Humana | Commercial | $2,794.50 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,859.26 | ↑ +53% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
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Clsd tx fx radius/ulna dist w/manip 25605 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,637.80 | $166.00 – $4,850.40 |
| UPMC Carlisle | Carlisle | $2,055.00 | $210.82 – $2,911.25 |
| UPMC Cole | Coudersport | $1,941.60 | $132.50 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $2,055.00 | $210.82 – $2,911.25 |
| UPMC East | Monroeville | $3,504.60 | $182.60 – $4,672.80 |
| UPMC Hamot | Erie | $3,582.60 | $182.60 – $2,219.16 |
| UPMC Northwest | Seneca | $2,509.80 | $182.60 – $1,602.09 |
| UPMC Hanover | Hanover | $2,055.00 | $210.82 – $2,446.19 |