Gamunex-c/gammaked at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$345.60
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.
$434.00
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.
$17.66 with Aetna of PA vs $386.10 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 |
|---|---|---|---|
| Aetna of PA | Medicare | $17.66 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $30.92 | ↓ -91% |
| UPMC Health Plan | Managed Medicare | $42.22 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $48.96 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $48.96 | ↓ -86% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $48.96 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $48.96 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $48.96 | ↓ -86% |
| Aetna | Medicare | $50.43 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $50.54 | ↓ -85% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $51.41 | ↓ -85% |
| United Healthcare | Medicare | $52.39 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicare | $52.87 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $52.88 | ↓ -85% |
| Cigna | Medicare | $52.88 | ↓ -85% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $52.88 | ↓ -85% |
| United Healthcare Community Plan for Families | Unison Kids | $56.30 | ↓ -84% |
| UPMC Health Plan | CHIP | $57.77 | ↓ -83% |
| UPMC Health Plan | Commercial | $60.23 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $124.58 | ↓ -64% |
| United Healthcare | Compass Exchange | $147.03 | ↓ -57% |
| United Healthcare | All Business | $147.03 | ↓ -57% |
| Aetna | EBR ASO | $171.60 | ↓ -50% |
| Cigna | EBR | $171.60 | ↓ -50% |
| Cigna | Commercial | $171.60 | ↓ -50% |
| Aetna | EBR FI | $210.21 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $254.02 | ↓ -26% |
| Aetna | Neighborhood Network | $265.98 | ↓ -23% |
| Aetna | Home Depot Employer Group | $273.27 | ↓ -21% |
| Cigna | NBR ASO/FI | $278.85 | ↓ -19% |
| InterGroup | PPO | $278.85 | ↓ -19% |
| Cigna | New Business ASO | $278.85 | ↓ -19% |
| Aetna | NBR ASO/FI | $278.85 | ↓ -19% |
| Coventry/First Health | Commercial | $300.30 | ↓ -13% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $312.93 | ↓ -9% |
| Preferred Healthcare System | PPO | $343.20 | ↓ -1% |
| Private Health Care Systems | PPO | $386.10 | ↑ +12% |
| Humana | Commercial | $386.10 | ↑ +12% |
| SelectCare | Commercial | $386.10 | ↑ +12% |
| Health Coalition Partners | Intergroup | $386.10 | ↑ +12% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Gamunex-c/gammaked at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $359.20 | $30.92 – $324.80 |
| UPMC Cole | Coudersport | $3,381.60 | $48.96 – $2,486.40 |
| UPMC East | Monroeville | $433.60 | $30.92 – $433.60 |
| UPMC Hamot | Erie | $362.40 | $30.92 – $90.45 |
| UPMC Northwest | Seneca | $345.60 | $30.92 – $52.88 |
| UPMC Horizon-Greenville | Greenville | $343.20 | $30.92 – $91.87 |
| UPMC Jameson | New Castle | $616.80 | $30.92 – $93.22 |
| UPMC Magee | Pittsburgh | $19,430.40 | $30.92 – $92.47 |