Idursulfase injection at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$8,137.60
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.
$10,172.00
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.
$201.49 with Aetna of PA vs $9,154.80 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 | $201.49 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $352.61 | ↓ -96% |
| UPMC Health Plan | Managed Medicare | $481.62 | ↓ -94% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $558.46 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $558.46 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $558.46 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $558.46 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $558.46 | ↓ -93% |
| Aetna | Medicare | $575.21 | ↓ -93% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $576.44 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $586.38 | ↓ -93% |
| United Healthcare | Medicare | $597.55 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $603.08 | ↓ -93% |
| Cigna | Medicare | $603.14 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $603.14 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $603.14 | ↓ -93% |
| UPMC Health Plan | CHIP | $629.99 | ↓ -92% |
| United Healthcare Community Plan for Families | Unison Kids | $642.23 | ↓ -92% |
| UPMC Health Plan | Commercial | $686.90 | ↓ -92% |
| United Healthcare | All Business | $1,626.66 | ↓ -80% |
| United Healthcare | Compass Exchange | $1,626.66 | ↓ -80% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,574.05 | ↓ -68% |
| UPMC Work Partners | Workers Comp | $2,953.95 | ↓ -64% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $3,170.99 | ↓ -61% |
| Aetna | EBR ASO | $4,068.80 | ↓ -50% |
| Cigna | Commercial | $4,068.80 | ↓ -50% |
| Cigna | EBR | $4,068.80 | ↓ -50% |
| Aetna | EBR FI | $4,984.28 | ↓ -39% |
| Aetna | Neighborhood Network | $6,306.64 | ↓ -23% |
| Aetna | Home Depot Employer Group | $6,479.56 | ↓ -20% |
| Cigna | New Business ASO | $6,611.80 | ↓ -19% |
| Aetna | NBR ASO/FI | $6,611.80 | ↓ -19% |
| InterGroup | PPO | $6,611.80 | ↓ -19% |
| Cigna | NBR ASO/FI | $6,611.80 | ↓ -19% |
| Coventry/First Health | Commercial | $7,120.40 | ↓ -13% |
| Preferred Healthcare System | PPO | $8,137.60 | ↑ +0% |
| Private Health Care Systems | PPO | $9,154.80 | ↑ +13% |
| SelectCare | Commercial | $9,154.80 | ↑ +13% |
| Humana | Commercial | $9,154.80 | ↑ +13% |
| Health Coalition Partners | Intergroup | $9,154.80 | ↑ +13% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Idursulfase injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $7,835.20 | $352.61 – $7,835.20 |
| UPMC Magee | Pittsburgh | $5,992.80 | $352.61 – $937.05 |
| UPMC Passavant-McCandless | Pittsburgh | $6,966.00 | $352.61 – $937.05 |