Consultation pathology during surgery frozen section first tissue block at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$133.20
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.
$222.00
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.
$28.50 with UPMC Health Plan vs $199.91 with UPMC Work 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 | $28.50 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $32.50 | ↓ -76% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $34.12 | ↓ -74% |
| UPMC Health Plan | Managed Medicaid | $35.75 | ↓ -73% |
| United Healthcare Community Plan for Families | Unison Kids | $37.38 | ↓ -72% |
| Aetna | Medicaid | $40.62 | ↓ -70% |
| Geisinger | Medicaid/CHIP | $45.17 | ↓ -66% |
| Highmark Wholecare (prev Gateway) | Medicaid | $48.20 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $50.74 | ↓ -62% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $55.39 | ↓ -58% |
| Aetna of PA | Medicare | $58.94 | ↓ -56% |
| Cigna | EBR | $88.80 | ↓ -33% |
| Aetna | EBR ASO | $88.80 | ↓ -33% |
| Cigna | Commercial | $88.80 | ↓ -33% |
| UPMC Health Plan | CHIP | $102.20 | ↓ -23% |
| Aetna | EBR FI | $108.78 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $108.82 | ↓ -18% |
| United Healthcare | Compass Exchange | $122.10 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $134.05 | ↑ +1% |
| Aetna | Neighborhood Network | $137.64 | ↑ +3% |
| UPMC Health Plan | Managed Medicare | $140.89 | ↑ +6% |
| Aetna | Home Depot Employer Group | $141.41 | ↑ +6% |
| Cigna | NBR ASO/FI | $144.30 | ↑ +8% |
| Aetna | NBR ASO/FI | $144.30 | ↑ +8% |
| United Healthcare | All Business | $144.30 | ↑ +8% |
| InterGroup | PPO | $144.30 | ↑ +8% |
| Cigna | New Business ASO | $144.30 | ↑ +8% |
| Coventry/First Health | Commercial | $155.40 | ↑ +17% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $163.37 | ↑ +23% |
| Aetna | Medicare | $168.27 | ↑ +26% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $168.63 | ↑ +27% |
| United Healthcare | Medicare | $174.81 | ↑ +31% |
| Highmark Wholecare (prev Gateway) | Medicare | $176.42 | ↑ +32% |
| AmeriHealth Caritas | Medicare | $176.44 | ↑ +32% |
| Cigna | Medicare | $176.44 | ↑ +32% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $176.44 | ↑ +32% |
| Preferred Healthcare System | PPO | $177.60 | ↑ +33% |
| Private Health Care Systems | PPO | $199.80 | ↑ +50% |
| SelectCare | Commercial | $199.80 | ↑ +50% |
| Humana | Commercial | $199.80 | ↑ +50% |
| Health Coalition Partners | Intergroup | $199.80 | ↑ +50% |
| UPMC Work Partners | Workers Comp | $199.91 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Consultation pathology during surgery frozen section first tissue block at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $229.80 | $7.50 – $306.40 |
| UPMC Carlisle | Carlisle | $337.20 | $9.82 – $477.70 |
| UPMC Cole | Coudersport | $104.40 | $34.12 – $199.91 |
| UPMC Community Osteopathic | Harrisburg | $337.20 | $9.82 – $211.89 |
| UPMC East | Monroeville | $303.00 | $28.11 – $404.00 |
| UPMC Hamot | Erie | $717.00 | $23.43 – $213.56 |
| UPMC Northwest | Seneca | $159.60 | $28.38 – $202.47 |
| UPMC Hanover | Hanover | $337.20 | $9.82 – $261.92 |