Kyleena, 19.5 mg at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$2,561.60
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.
$3,202.00
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.
$800.50 with Aetna vs $2,881.80 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 | Medicare | $800.50 | ↓ -69% |
| UPMC Work Partners | Workers Comp | $929.86 | ↓ -64% |
| UPMC Health Plan | CHIP | $1,120.70 | ↓ -56% |
| Aetna | EBR ASO | $1,280.80 | ↓ -50% |
| Cigna | Commercial | $1,280.80 | ↓ -50% |
| Cigna | EBR | $1,280.80 | ↓ -50% |
| Aetna | EBR FI | $1,568.98 | ↓ -39% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,601.00 | ↓ -38% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,720.90 | ↓ -33% |
| Geisinger | Medicaid/CHIP | $1,761.10 | ↓ -31% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,761.10 | ↓ -31% |
| United Healthcare | Compass Exchange | $1,825.14 | ↓ -29% |
| Aetna | Neighborhood Network | $1,985.24 | ↓ -23% |
| Aetna | Home Depot Employer Group | $2,039.67 | ↓ -20% |
| Cigna | NBR ASO/FI | $2,081.30 | ↓ -19% |
| Aetna | NBR ASO/FI | $2,081.30 | ↓ -19% |
| Cigna | New Business ASO | $2,081.30 | ↓ -19% |
| InterGroup | PPO | $2,081.30 | ↓ -19% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,119.98 | ↓ -17% |
| United Healthcare | All Business | $2,145.34 | ↓ -16% |
| Coventry/First Health | Commercial | $2,241.40 | ↓ -13% |
| UPMC Health Plan | Commercial | $2,279.82 | ↓ -11% |
| Preferred Healthcare System | PPO | $2,561.60 | ↑ +0% |
| Health Coalition Partners | Intergroup | $2,881.80 | ↑ +13% |
| SelectCare | Commercial | $2,881.80 | ↑ +13% |
| Private Health Care Systems | PPO | $2,881.80 | ↑ +13% |
| Humana | Commercial | $2,881.80 | ↑ +13% |
Visitor-reported prices
Comments
Kyleena, 19.5 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,489.60 | $620.56 – $4,164.45 |
| UPMC Cole | Coudersport | $3,024.00 | $1,384.68 – $4,032.00 |
| UPMC Hamot | Erie | $2,561.60 | $620.56 – $3,779.24 |
| UPMC Horizon-Greenville | Greenville | $2,561.60 | $1,388.15 – $1,581.55 |
| UPMC Kane | Kane | $1,372.80 | $1,384.68 – $2,290.45 |
| UPMC Magee | Pittsburgh | $2,036.40 | $626.47 – $1,384.68 |
| UPMC Muncy | Muncy | $2,489.60 | $1,200.72 – $1,200.72 |
| UPMC Passavant-McCandless | Pittsburgh | $2,036.40 | $626.47 – $1,318.74 |