Complx repair fccmnaxghf 13133 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$604.80
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.
$1,008.00
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.
$252.00 with Aetna vs $1,435.39 with UPMC Health Plan — 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 | Medicare | $252.00 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $262.09 | ↓ -57% |
| Cigna | EBR | $403.20 | ↓ -33% |
| Aetna | EBR ASO | $403.20 | ↓ -33% |
| Cigna | Commercial | $403.20 | ↓ -33% |
| Aetna | EBR FI | $493.92 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $504.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $554.40 | ↓ -8% |
| United Healthcare | Compass Exchange | $554.40 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $554.40 | ↓ -8% |
| Aetna | Neighborhood Network | $624.96 | ↑ +3% |
| Aetna | Home Depot Employer Group | $642.10 | ↑ +6% |
| Cigna | NBR ASO/FI | $655.20 | ↑ +8% |
| United Healthcare | All Business | $655.20 | ↑ +8% |
| Aetna | NBR ASO/FI | $655.20 | ↑ +8% |
| Cigna | New Business ASO | $655.20 | ↑ +8% |
| InterGroup | PPO | $655.20 | ↑ +8% |
| Coventry/First Health | Commercial | $705.60 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $753.20 | ↑ +25% |
| UPMC Health Plan | Commercial | $791.70 | ↑ +31% |
| Preferred Healthcare System | PPO | $806.40 | ↑ +33% |
| Private Health Care Systems | PPO | $907.20 | ↑ +50% |
| SelectCare | Commercial | $907.20 | ↑ +50% |
| Health Coalition Partners | Intergroup | $907.20 | ↑ +50% |
| Humana | Commercial | $907.20 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $927.88 | ↑ +53% |
| UPMC Health Plan | CHIP | $1,435.39 | ↑ +137% |
Visitor-reported prices
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Complx repair fccmnaxghf 13133 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $660.60 | $262.09 – $1,435.39 |
| UPMC Carlisle | Carlisle | $1,089.00 | $141.10 – $1,542.75 |
| UPMC Cole | Coudersport | $635.40 | $108.94 – $1,470.59 |
| UPMC Community Osteopathic | Harrisburg | $1,089.00 | $141.10 – $1,542.75 |
| UPMC East | Monroeville | $1,380.00 | $262.09 – $1,840.00 |
| UPMC Hamot | Erie | $596.40 | $262.09 – $1,782.09 |
| UPMC Northwest | Seneca | $1,718.40 | $262.09 – $704.93 |
| UPMC Hanover | Hanover | $1,089.00 | $141.10 – $1,435.39 |