Injection, inclisiran, 1 mg at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$43.60
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.
?
What you pay up front if you don't use insurance.
$54.50
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.
?
The hospital's undiscounted list price — almost no one pays this.
$4.45 with Aetna of PA vs $34.20 with Health Coalition Partners — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $4.45 | ↓ -90% |
| UPMC Health Plan | Managed Medicaid | $7.78 | ↓ -82% |
| UPMC Health Plan | Managed Medicare | $10.62 | ↓ -76% |
| UPMC Work Partners | Workers Comp | $11.04 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicaid | $12.32 | ↓ -72% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $12.32 | ↓ -72% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $12.32 | ↓ -72% |
| Geisinger | Medicaid/CHIP | $12.32 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $12.32 | ↓ -72% |
| Aetna | Medicare | $12.69 | ↓ -71% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $12.72 | ↓ -71% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $12.94 | ↓ -70% |
| United Healthcare | Medicare | $13.18 | ↓ -70% |
| Highmark Wholecare (prev Gateway) | Medicare | $13.30 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $13.31 | ↓ -69% |
| Cigna | Medicare | $13.31 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $13.31 | ↓ -69% |
| UPMC Health Plan | CHIP | $14.08 | ↓ -68% |
| United Healthcare Community Plan for Families | Unison Kids | $14.17 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $14.43 | ↓ -67% |
| UPMC Health Plan | Commercial | $15.15 | ↓ -65% |
| Aetna | EBR ASO | $15.20 | ↓ -65% |
| Cigna | EBR | $15.20 | ↓ -65% |
| Cigna | Commercial | $15.20 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $17.78 | ↓ -59% |
| Aetna | EBR FI | $18.62 | ↓ -57% |
| United Healthcare | Compass Exchange | $21.66 | ↓ -50% |
| Aetna | Neighborhood Network | $23.56 | ↓ -46% |
| Aetna | Home Depot Employer Group | $24.21 | ↓ -44% |
| Cigna | New Business ASO | $24.70 | ↓ -43% |
| InterGroup | PPO | $24.70 | ↓ -43% |
| Aetna | NBR ASO/FI | $24.70 | ↓ -43% |
| Cigna | NBR ASO/FI | $24.70 | ↓ -43% |
| United Healthcare | All Business | $25.46 | ↓ -42% |
| Coventry/First Health | Commercial | $26.60 | ↓ -39% |
| Preferred Healthcare System | PPO | $30.40 | ↓ -30% |
| Private Health Care Systems | PPO | $34.20 | ↓ -22% |
| SelectCare | Commercial | $34.20 | ↓ -22% |
| Humana | Commercial | $34.20 | ↓ -22% |
| Health Coalition Partners | Intergroup | $34.20 | ↓ -22% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Injection, inclisiran, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,348.80 | $12.20 – $1,910.80 |
| UPMC Community Osteopathic | Harrisburg | $1,348.80 | $8.67 – $1,910.80 |
| UPMC Hanover | Hanover | $1,348.80 | $12.20 – $19.71 |
| UPMC Lititz | Lititz | $1,348.80 | $12.20 – $19.71 |
| UPMC Memorial | York | $1,348.80 | $4.24 – $19.71 |
| UPMC Somerset | Somerset | $1,348.80 | $5.15 – $12.32 |