healthcosts.net
Knee X-ray at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$133.20
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.
$222.00
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.
$36.58 with Aetna of PA vs $199.80 with SelectCare — 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 | $36.58 | ↓ -73% |
| UPMC Health Plan | Commercial | $37.72 | ↓ -72% |
| UPMC Work Partners | Workers Comp | $82.10 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $87.43 | ↓ -34% |
| Cigna | EBR | $88.80 | ↓ -33% |
| Cigna | Commercial | $88.80 | ↓ -33% |
| Aetna | EBR ASO | $88.80 | ↓ -33% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $101.38 | ↓ -24% |
| Aetna | Medicare | $104.42 | ↓ -22% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $104.64 | ↓ -21% |
| United Healthcare | Medicare | $108.48 | ↓ -19% |
| Aetna | EBR FI | $108.78 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -18% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -18% |
| Cigna | Medicare | $109.49 | ↓ -18% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $112.37 | ↓ -16% |
| Geisinger | Medicaid/CHIP | $122.10 | ↓ -8% |
| United Healthcare | Compass Exchange | $122.10 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $122.10 | ↓ -8% |
| UPMC Health Plan | CHIP | $135.24 | ↑ +2% |
| Aetna | Neighborhood Network | $137.64 | ↑ +3% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $138.43 | ↑ +4% |
| Aetna | Home Depot Employer Group | $141.41 | ↑ +6% |
| Cigna | NBR ASO/FI | $144.30 | ↑ +8% |
| Aetna | NBR ASO/FI | $144.30 | ↑ +8% |
| Cigna | New Business ASO | $144.30 | ↑ +8% |
| United Healthcare | All Business | $144.30 | ↑ +8% |
| InterGroup | PPO | $144.30 | ↑ +8% |
| Coventry/First Health | Commercial | $155.40 | ↑ +17% |
| Preferred Healthcare System | PPO | $177.60 | ↑ +33% |
| Health Coalition Partners | Intergroup | $199.80 | ↑ +50% |
| Private Health Care Systems | PPO | $199.80 | ↑ +50% |
| Humana | Commercial | $199.80 | ↑ +50% |
| SelectCare | Commercial | $199.80 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Knee X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $436.20 | $37.20 – $581.60 |
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $37.53 – $594.15 |
| UPMC Hamot | Erie | $473.40 | $25.96 – $552.30 |
| UPMC Carlisle | Carlisle | $262.80 | $29.37 – $589.04 |
| UPMC Altoona | Altoona | $186.60 | $40.52 – $248.80 |
| UPMC Cole | Coudersport | $215.40 | $42.48 – $287.20 |
| UPMC Community Osteopathic | Harrisburg | $262.80 | $29.37 – $372.30 |
| UPMC Hanover | Hanover | $262.80 | $29.37 – $589.04 |