Exc snhfg mal+mrg >4 cm 11626 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
not published by hospital
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.
not published by hospital
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 United Healthcare Community Plan for Families vs $2,946.91 with AmeriHealth Caritas — 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 | $252.00 | — |
| UPMC Health Plan | Managed Medicaid | $264.00 | — |
| United Healthcare Community Plan for Families | Unison Kids | $276.00 | — |
| Aetna | Medicaid | $300.00 | — |
| Geisinger | Medicaid/CHIP | $333.58 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $355.92 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $361.92 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $374.66 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $409.01 | — |
| UPMC Work Partners | Workers Comp | $776.92 | — |
| Aetna of PA | Medicare | $984.49 | — |
| UPMC Health Plan | Commercial | $1,267.60 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,023.84 | — |
| UPMC Health Plan | CHIP | $2,298.24 | — |
| UPMC Health Plan | Managed Medicare | $2,353.16 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,493.18 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $2,728.62 | — |
| Aetna | Medicare | $2,810.48 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $2,816.48 | — |
| United Healthcare | Medicare | $2,919.62 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $2,946.64 | — |
| Cigna | Medicare | $2,946.91 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,946.91 | — |
| AmeriHealth Caritas | Medicare | $2,946.91 | — |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc snhfg mal+mrg >4 cm 11626 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $376.80 | $76.78 – $1,041.88 |
| UPMC Kane | Kane | $2,174.40 | $264.00 – $1,705.64 |
| UPMC Presbyterian | Pittsburgh | $2,752.20 | $264.00 – $3,001.48 |
| UPMC St. Margaret | Pittsburgh | $3,448.20 | $264.00 – $791.78 |
| UPMC Altoona | Altoona | not published | $240.00 – $2,946.91 |
| UPMC Carlisle | Carlisle | not published | $304.80 – $4,380.62 |
| UPMC Hamot | Erie | not published | $264.00 – $3,968.58 |
| UPMC Northwest | Seneca | not published | $264.00 – $2,865.05 |