Clsd tx trimall ankle fx without manip 27816 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$3,647.40
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.
$6,079.00
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.
$82.51 with Aetna of PA vs $5,471.10 with Private Health Care Systems — 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 | $82.51 | ↓ -98% |
| UPMC Health Plan | Managed Medicare | $197.23 | ↓ -95% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $228.70 | ↓ -94% |
| Aetna | Medicare | $235.56 | ↓ -94% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $236.06 | ↓ -94% |
| United Healthcare | Medicare | $244.71 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $246.97 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $247.00 | ↓ -93% |
| Cigna | Medicare | $247.00 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.00 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $731.96 | ↓ -80% |
| UPMC Health Plan | Commercial | $944.46 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,511.46 | ↓ -59% |
| UPMC Health Plan | CHIP | $1,712.37 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $1,861.98 | ↓ -49% |
| Cigna | EBR | $2,431.60 | ↓ -33% |
| Cigna | Commercial | $2,431.60 | ↓ -33% |
| Aetna | EBR ASO | $2,431.60 | ↓ -33% |
| Aetna | EBR FI | $2,978.71 | ↓ -18% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,343.45 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $3,343.45 | ↓ -8% |
| United Healthcare | Compass Exchange | $3,343.45 | ↓ -8% |
| Aetna | Neighborhood Network | $3,768.98 | ↑ +3% |
| Aetna | Home Depot Employer Group | $3,872.32 | ↑ +6% |
| Cigna | NBR ASO/FI | $3,951.35 | ↑ +8% |
| United Healthcare | All Business | $3,951.35 | ↑ +8% |
| Aetna | NBR ASO/FI | $3,951.35 | ↑ +8% |
| Cigna | New Business ASO | $3,951.35 | ↑ +8% |
| InterGroup | PPO | $3,951.35 | ↑ +8% |
| Coventry/First Health | Commercial | $4,255.30 | ↑ +17% |
| Preferred Healthcare System | PPO | $4,863.20 | ↑ +33% |
| Health Coalition Partners | Intergroup | $5,471.10 | ↑ +50% |
| Humana | Commercial | $5,471.10 | ↑ +50% |
| SelectCare | Commercial | $5,471.10 | ↑ +50% |
| Private Health Care Systems | PPO | $5,471.10 | ↑ +50% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx trimall ankle fx without manip 27816 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,505.20 | $233.23 – $4,673.60 |
| UPMC Carlisle | Carlisle | $488.40 | $111.52 – $1,016.56 |
| UPMC Cole | Coudersport | $1,266.00 | $66.81 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $488.40 | $162.80 – $1,712.37 |
| UPMC East | Monroeville | $2,812.80 | $229.32 – $3,750.40 |
| UPMC Hamot | Erie | $2,223.60 | $263.94 – $755.74 |
| UPMC Hanover | Hanover | $488.40 | $226.87 – $1,712.37 |
| UPMC Jameson | New Castle | $379.80 | $228.70 – $892.40 |