Immunoassay tumor antigen quantitative ca 19-9 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$336.00
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.
$560.00
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.
$7.51 with Aetna of PA vs $504.00 with Humana — 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 | $7.51 | ↓ -98% |
| UPMC Health Plan | Managed Medicare | $17.95 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $20.57 | ↓ -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 | $20.81 | ↓ -94% |
| Aetna | Medicare | $21.43 | ↓ -94% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $21.48 | ↓ -94% |
| United Healthcare | Medicare | $22.27 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $22.47 | ↓ -93% |
| AmeriHealth Caritas | Medicare | $22.47 | ↓ -93% |
| Cigna | Medicare | $22.47 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicare | $22.47 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $23.01 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $24.16 | ↓ -93% |
| UPMC Health Plan | Commercial | $24.52 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $25.31 | ↓ -92% |
| United Healthcare Community Plan for Families | Unison Kids | $26.46 | ↓ -92% |
| Aetna | Medicaid | $28.76 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $31.98 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $34.12 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $35.92 | ↓ -89% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $39.21 | ↓ -88% |
| UPMC Health Plan | CHIP | $87.92 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $153.20 | ↓ -54% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $188.72 | ↓ -44% |
| Aetna | EBR ASO | $224.00 | ↓ -33% |
| Cigna | EBR | $224.00 | ↓ -33% |
| Cigna | Commercial | $224.00 | ↓ -33% |
| Aetna | EBR FI | $274.40 | ↓ -18% |
| United Healthcare | Compass Exchange | $308.00 | ↓ -8% |
| Aetna | Neighborhood Network | $347.20 | ↑ +3% |
| Aetna | Home Depot Employer Group | $356.72 | ↑ +6% |
| Cigna | NBR ASO/FI | $364.00 | ↑ +8% |
| Aetna | NBR ASO/FI | $364.00 | ↑ +8% |
| United Healthcare | All Business | $364.00 | ↑ +8% |
| InterGroup | PPO | $364.00 | ↑ +8% |
| Cigna | New Business ASO | $364.00 | ↑ +8% |
| Coventry/First Health | Commercial | $392.00 | ↑ +17% |
| Preferred Healthcare System | PPO | $448.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $504.00 | ↑ +50% |
| SelectCare | Commercial | $504.00 | ↑ +50% |
| Private Health Care Systems | PPO | $504.00 | ↑ +50% |
| Humana | Commercial | $504.00 | ↑ +50% |
Visitor-reported prices
Comments
Immunoassay tumor antigen quantitative ca 19-9 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $202.20 | $20.57 – $269.60 |
| UPMC Carlisle | Carlisle | $116.40 | $20.60 – $164.90 |
| UPMC Cole | Coudersport | $198.60 | $13.53 – $264.80 |
| UPMC Community Osteopathic | Harrisburg | $116.40 | $20.60 – $164.90 |
| UPMC East | Monroeville | $427.20 | $20.57 – $569.60 |
| UPMC Hamot | Erie | $193.20 | $20.57 – $55.24 |
| UPMC Northwest | Seneca | $141.00 | $18.87 – $26.46 |
| UPMC Hanover | Hanover | $116.40 | $20.60 – $33.30 |