Colonoscopy submucous njx at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$5,152.80
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.
$8,588.00
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.
$137.39 with UPMC Health Plan vs $7,729.20 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $137.39 | ↓ -97% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $223.87 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $234.53 | ↓ -95% |
| United Healthcare Community Plan for Families | Unison Kids | $245.19 | ↓ -95% |
| UPMC Health Plan | CHIP | $249.09 | ↓ -95% |
| Aetna | Medicaid | $266.51 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $296.34 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $316.19 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $321.52 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $332.84 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $363.35 | ↓ -93% |
| Aetna of PA | Medicare | $405.58 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $715.89 | ↓ -86% |
| UPMC Health Plan | Managed Medicare | $969.43 | ↓ -81% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,124.11 | ↓ -78% |
| Aetna | Medicare | $1,157.83 | ↓ -78% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,160.31 | ↓ -77% |
| United Healthcare | Medicare | $1,202.80 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,213.93 | ↓ -76% |
| Cigna | Medicare | $1,214.04 | ↓ -76% |
| AmeriHealth Caritas | Medicare | $1,214.04 | ↓ -76% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,214.04 | ↓ -76% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,177.19 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,682.09 | ↓ -48% |
| Cigna | EBR | $3,435.20 | ↓ -33% |
| Cigna | Commercial | $3,435.20 | ↓ -33% |
| Aetna | EBR ASO | $3,435.20 | ↓ -33% |
| Aetna | EBR FI | $4,208.12 | ↓ -18% |
| United Healthcare | Compass Exchange | $4,723.40 | ↓ -8% |
| Aetna | Neighborhood Network | $5,324.56 | ↑ +3% |
| Aetna | Home Depot Employer Group | $5,470.56 | ↑ +6% |
| Aetna | NBR ASO/FI | $5,582.20 | ↑ +8% |
| United Healthcare | All Business | $5,582.20 | ↑ +8% |
| InterGroup | PPO | $5,582.20 | ↑ +8% |
| Cigna | New Business ASO | $5,582.20 | ↑ +8% |
| Cigna | NBR ASO/FI | $5,582.20 | ↑ +8% |
| Coventry/First Health | Commercial | $6,011.60 | ↑ +17% |
| Preferred Healthcare System | PPO | $6,870.40 | ↑ +33% |
| Humana | Commercial | $7,729.20 | ↑ +50% |
| SelectCare | Commercial | $7,729.20 | ↑ +50% |
| Private Health Care Systems | PPO | $7,729.20 | ↑ +50% |
| Health Coalition Partners | Intergroup | $7,729.20 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy submucous njx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,764.60 | $213.21 – $2,352.80 |
| UPMC Cole | Coudersport | $687.00 | $223.87 – $1,041.88 |
| UPMC East | Monroeville | $3,903.60 | $234.53 – $5,204.80 |
| UPMC Hamot | Erie | $1,927.80 | $234.53 – $1,634.95 |
| UPMC Northwest | Seneca | $4,867.20 | $117.67 – $1,180.32 |
| UPMC Horizon-Greenville | Greenville | $3,696.60 | $135.12 – $1,527.37 |
| UPMC Jameson | New Castle | $3,696.60 | $234.53 – $1,517.55 |
| UPMC Kane | Kane | $1,506.60 | $183.42 – $1,849.45 |