healthcosts.net
ER Visit (level 5, high severity) at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$903.60
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.
$1,506.00
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.
$145.68 with United Healthcare Community Plan for Families vs $1,355.40 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | Unison MedPLUS | $145.68 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $152.61 | ↓ -83% |
| United Healthcare Community Plan for Families | Unison Kids | $159.55 | ↓ -82% |
| Aetna | Medicaid | $173.43 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $192.83 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $209.22 | ↓ -77% |
| Aetna of PA | Medicare | $210.89 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $216.59 | ↓ -76% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $236.44 | ↓ -74% |
| UPMC Work Partners | Workers Comp | $258.18 | ↓ -71% |
| UPMC Health Plan | Commercial | $474.47 | ↓ -47% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $483.10 | ↓ -47% |
| UPMC Health Plan | Managed Medicare | $504.09 | ↓ -44% |
| UPMC Health Plan | CHIP | $547.01 | ↓ -39% |
| Highmark Wholecare (prev Gateway) | Medicaid | $551.50 | ↓ -39% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $584.52 | ↓ -35% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $595.13 | ↓ -34% |
| Aetna | Medicare | $602.06 | ↓ -33% |
| Cigna | EBR | $602.40 | ↓ -33% |
| Cigna | Commercial | $602.40 | ↓ -33% |
| Aetna | EBR ASO | $602.40 | ↓ -33% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $603.34 | ↓ -33% |
| United Healthcare | Medicare | $625.44 | ↓ -31% |
| Highmark Wholecare (prev Gateway) | Medicare | $631.22 | ↓ -30% |
| AmeriHealth Caritas | Medicare | $631.28 | ↓ -30% |
| Cigna | Medicare | $631.28 | ↓ -30% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $631.28 | ↓ -30% |
| Aetna | EBR FI | $737.94 | ↓ -18% |
| United Healthcare | Compass Exchange | $828.30 | ↓ -8% |
| Aetna | Neighborhood Network | $933.72 | ↑ +3% |
| Aetna | Home Depot Employer Group | $959.32 | ↑ +6% |
| Cigna | NBR ASO/FI | $978.90 | ↑ +8% |
| Aetna | NBR ASO/FI | $978.90 | ↑ +8% |
| Cigna | New Business ASO | $978.90 | ↑ +8% |
| United Healthcare | All Business | $978.90 | ↑ +8% |
| InterGroup | PPO | $978.90 | ↑ +8% |
| Coventry/First Health | Commercial | $1,054.20 | ↑ +17% |
| Preferred Healthcare System | PPO | $1,204.80 | ↑ +33% |
| Health Coalition Partners | Intergroup | $1,355.40 | ↑ +50% |
| Private Health Care Systems | PPO | $1,355.40 | ↑ +50% |
| Humana | Commercial | $1,355.40 | ↑ +50% |
| SelectCare | Commercial | $1,355.40 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $1,371.00 | $152.61 – $1,828.00 |
| UPMC Passavant-McCandless | Pittsburgh | $1,798.20 | $152.61 – $2,547.45 |
| UPMC Hamot | Erie | $2,165.40 | $152.61 – $2,526.30 |
| UPMC Carlisle | Carlisle | $1,828.80 | $65.00 – $2,590.80 |
| UPMC Altoona | Altoona | $1,449.00 | $174.21 – $1,932.00 |
| UPMC Cole | Coudersport | $630.00 | $56.38 – $553.93 |
| UPMC Community Osteopathic | Harrisburg | $1,828.80 | $65.00 – $645.31 |
| UPMC Hanover | Hanover | $1,828.80 | $152.61 – $2,651.76 |