Ghs layer closure 5.1 - 7.5 cm - 12053 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$428.40
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.
$714.00
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.
$49.88 with United Healthcare Community Plan for Families vs $698.51 with Highmark BCBS of PA — 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 | $49.88 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $52.25 | ↓ -88% |
| United Healthcare Community Plan for Families | Unison Kids | $54.62 | ↓ -87% |
| Aetna | Medicaid | $59.38 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $66.02 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $70.44 | ↓ -84% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $71.63 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $74.15 | ↓ -83% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $80.95 | ↓ -81% |
| Aetna of PA | Medicare | $137.43 | ↓ -68% |
| Cigna | EBR | $285.60 | ↓ -33% |
| Cigna | Commercial | $285.60 | ↓ -33% |
| Aetna | EBR ASO | $285.60 | ↓ -33% |
| UPMC Health Plan | Managed Medicare | $328.49 | ↓ -23% |
| Aetna | EBR FI | $349.86 | ↓ -18% |
| UPMC Health Plan | Commercial | $360.51 | ↓ -16% |
| UPMC Work Partners | Workers Comp | $374.81 | ↓ -13% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $380.90 | ↓ -11% |
| Aetna | Medicare | $392.33 | ↓ -8% |
| United Healthcare | Compass Exchange | $392.70 | ↓ -8% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $393.16 | ↓ -8% |
| United Healthcare | Medicare | $407.56 | ↓ -5% |
| Highmark Wholecare (prev Gateway) | Medicare | $411.33 | ↓ -4% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $411.37 | ↓ -4% |
| Cigna | Medicare | $411.37 | ↓ -4% |
| AmeriHealth Caritas | Medicare | $411.37 | ↓ -4% |
| Aetna | Neighborhood Network | $442.68 | ↑ +3% |
| Aetna | Home Depot Employer Group | $454.82 | ↑ +6% |
| Aetna | NBR ASO/FI | $464.10 | ↑ +8% |
| United Healthcare | All Business | $464.10 | ↑ +8% |
| InterGroup | PPO | $464.10 | ↑ +8% |
| Cigna | New Business ASO | $464.10 | ↑ +8% |
| Cigna | NBR ASO/FI | $464.10 | ↑ +8% |
| Coventry/First Health | Commercial | $499.80 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $567.02 | ↑ +32% |
| Preferred Healthcare System | PPO | $571.20 | ↑ +33% |
| SelectCare | Commercial | $642.60 | ↑ +50% |
| Private Health Care Systems | PPO | $642.60 | ↑ +50% |
| Health Coalition Partners | Intergroup | $642.60 | ↑ +50% |
| Humana | Commercial | $642.60 | ↑ +50% |
| UPMC Health Plan | CHIP | $653.63 | ↑ +53% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $698.51 | ↑ +63% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs layer closure 5.1 - 7.5 cm - 12053 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $909.00 | $47.50 – $1,212.00 |
| UPMC Carlisle | Carlisle | $819.00 | $60.33 – $1,160.25 |
| UPMC Cole | Coudersport | $1,084.80 | $49.88 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $819.00 | $60.33 – $1,160.25 |
| UPMC East | Monroeville | $1,037.40 | $52.25 – $1,383.20 |
| UPMC Hamot | Erie | $880.20 | $52.25 – $554.00 |
| UPMC Northwest | Seneca | $695.40 | $52.25 – $408.14 |
| UPMC Hanover | Hanover | $819.00 | $60.33 – $1,016.56 |