Fna bx w/mr gdn 1st les at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$1,597.80
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.
$2,663.00
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.
$140.95 with United Healthcare Community Plan for Families vs $2,396.70 with Health Coalition 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | Unison MedPLUS | $140.95 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $147.66 | ↓ -91% |
| United Healthcare Community Plan for Families | Unison Kids | $154.38 | ↓ -90% |
| Aetna | Medicaid | $167.80 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $186.58 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $199.08 | ↓ -88% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $202.43 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $209.56 | ↓ -87% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $210.98 | ↓ -87% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $228.77 | ↓ -86% |
| Aetna of PA | Medicare | $242.02 | ↓ -85% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $259.91 | ↓ -84% |
| UPMC Health Plan | Managed Medicare | $578.49 | ↓ -64% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $670.79 | ↓ -58% |
| Aetna | Medicare | $690.91 | ↓ -57% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $692.39 | ↓ -57% |
| United Healthcare | Medicare | $717.75 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $724.39 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $724.45 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $724.45 | ↓ -55% |
| Cigna | Medicare | $724.45 | ↓ -55% |
| UPMC Health Plan | CHIP | $932.05 | ↓ -42% |
| Aetna | EBR ASO | $1,065.20 | ↓ -33% |
| Cigna | Commercial | $1,065.20 | ↓ -33% |
| Cigna | EBR | $1,065.20 | ↓ -33% |
| Aetna | EBR FI | $1,304.87 | ↓ -18% |
| United Healthcare | Compass Exchange | $1,464.65 | ↓ -8% |
| Aetna | Neighborhood Network | $1,651.06 | ↑ +3% |
| Aetna | Home Depot Employer Group | $1,696.33 | ↑ +6% |
| Aetna | NBR ASO/FI | $1,730.95 | ↑ +8% |
| InterGroup | PPO | $1,730.95 | ↑ +8% |
| Cigna | NBR ASO/FI | $1,730.95 | ↑ +8% |
| Cigna | New Business ASO | $1,730.95 | ↑ +8% |
| United Healthcare | All Business | $1,730.95 | ↑ +8% |
| Coventry/First Health | Commercial | $1,864.10 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,896.06 | ↑ +19% |
| Preferred Healthcare System | PPO | $2,130.40 | ↑ +33% |
| Humana | Commercial | $2,396.70 | ↑ +50% |
| SelectCare | Commercial | $2,396.70 | ↑ +50% |
| Private Health Care Systems | PPO | $2,396.70 | ↑ +50% |
| Health Coalition Partners | Intergroup | $2,396.70 | ↑ +50% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
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Fna bx w/mr gdn 1st les at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $559.20 | $76.08 – $745.60 |
| UPMC Carlisle | Carlisle | $1,498.20 | $170.48 – $2,122.45 |
| UPMC Community Osteopathic | Harrisburg | $1,498.20 | $170.48 – $2,122.45 |
| UPMC Hamot | Erie | $543.60 | $76.08 – $975.61 |
| UPMC Hanover | Hanover | $1,498.20 | $170.48 – $1,075.42 |
| UPMC Horizon-Greenville | Greenville | $741.00 | $147.66 – $724.45 |
| UPMC Jameson | New Castle | $858.60 | $77.42 – $905.57 |
| UPMC Lititz | Lititz | $1,498.20 | $170.48 – $1,081.23 |