healthcosts.net
ER Visit (level 1, minor) at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$215.40
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.
$359.00
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.
$30.29 with Aetna of PA vs $323.10 with SelectCare — 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 | $30.29 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $48.64 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $66.90 | ↓ -69% |
| UPMC Health Plan | Managed Medicare | $72.40 | ↓ -66% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $83.95 | ↓ -61% |
| Aetna | Medicare | $86.47 | ↓ -60% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $86.65 | ↓ -60% |
| United Healthcare | Medicare | $89.83 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicare | $90.66 | ↓ -58% |
| AmeriHealth Caritas | Medicare | $90.67 | ↓ -58% |
| Cigna | Medicare | $90.67 | ↓ -58% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.67 | ↓ -58% |
| Cigna | EBR | $143.60 | ↓ -33% |
| Cigna | Commercial | $143.60 | ↓ -33% |
| Aetna | EBR ASO | $143.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $152.12 | ↓ -29% |
| UPMC Health Plan | Commercial | $153.25 | ↓ -29% |
| Aetna | EBR FI | $175.91 | ↓ -18% |
| UPMC Health Plan | CHIP | $176.68 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $187.39 | ↓ -13% |
| Geisinger | Medicaid/CHIP | $197.45 | ↓ -8% |
| United Healthcare | Compass Exchange | $197.45 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $197.45 | ↓ -8% |
| Aetna | Neighborhood Network | $222.58 | ↑ +3% |
| Aetna | Home Depot Employer Group | $228.68 | ↑ +6% |
| Cigna | NBR ASO/FI | $233.35 | ↑ +8% |
| Aetna | NBR ASO/FI | $233.35 | ↑ +8% |
| Cigna | New Business ASO | $233.35 | ↑ +8% |
| United Healthcare | All Business | $233.35 | ↑ +8% |
| InterGroup | PPO | $233.35 | ↑ +8% |
| Coventry/First Health | Commercial | $251.30 | ↑ +17% |
| Preferred Healthcare System | PPO | $287.20 | ↑ +33% |
| Health Coalition Partners | Intergroup | $323.10 | ↑ +50% |
| Private Health Care Systems | PPO | $323.10 | ↑ +50% |
| Humana | Commercial | $323.10 | ↑ +50% |
| SelectCare | Commercial | $323.10 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 1, minor) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $183.60 | $51.60 – $260.10 |
| UPMC East | Monroeville | $260.40 | $51.60 – $347.20 |
| UPMC Hamot | Erie | $384.60 | $51.60 – $448.70 |
| UPMC Carlisle | Carlisle | $391.20 | $21.05 – $554.20 |
| UPMC Altoona | Altoona | $374.40 | $21.00 – $499.20 |
| UPMC Cole | Coudersport | $136.20 | $18.26 – $103.74 |
| UPMC Community Osteopathic | Harrisburg | $391.20 | $21.05 – $554.20 |
| UPMC Hanover | Hanover | $391.20 | $53.65 – $567.24 |