Lipoprotein blood high res frac & quant at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$381.00
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.
$635.00
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.
$12.22 with Aetna of PA vs $571.50 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 | $12.22 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $27.74 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $29.13 | ↓ -92% |
| UPMC Health Plan | Managed Medicare | $29.20 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $30.51 | ↓ -92% |
| United Healthcare Community Plan for Families | Unison Kids | $31.90 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $33.46 | ↓ -91% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $33.86 | ↓ -91% |
| Aetna | Medicaid | $34.67 | ↓ -91% |
| Aetna | Medicare | $34.88 | ↓ -91% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $34.95 | ↓ -91% |
| United Healthcare | Medicare | $36.23 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $36.57 | ↓ -90% |
| AmeriHealth Caritas | Medicare | $36.57 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $36.57 | ↓ -90% |
| Cigna | Medicare | $36.57 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $38.56 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $41.14 | ↓ -89% |
| UPMC Health Plan | Commercial | $41.92 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $43.30 | ↓ -89% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $47.27 | ↓ -88% |
| UPMC Health Plan | CHIP | $150.30 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $178.76 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $220.22 | ↓ -42% |
| Cigna | EBR | $254.00 | ↓ -33% |
| Cigna | Commercial | $254.00 | ↓ -33% |
| Aetna | EBR ASO | $254.00 | ↓ -33% |
| Aetna | EBR FI | $311.15 | ↓ -18% |
| United Healthcare | Compass Exchange | $349.25 | ↓ -8% |
| Aetna | Neighborhood Network | $393.70 | ↑ +3% |
| Aetna | Home Depot Employer Group | $404.50 | ↑ +6% |
| United Healthcare | All Business | $412.75 | ↑ +8% |
| Aetna | NBR ASO/FI | $412.75 | ↑ +8% |
| Cigna | NBR ASO/FI | $412.75 | ↑ +8% |
| Cigna | New Business ASO | $412.75 | ↑ +8% |
| InterGroup | PPO | $412.75 | ↑ +8% |
| Coventry/First Health | Commercial | $444.50 | ↑ +17% |
| Preferred Healthcare System | PPO | $508.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $571.50 | ↑ +50% |
| SelectCare | Commercial | $571.50 | ↑ +50% |
| Private Health Care Systems | PPO | $571.50 | ↑ +50% |
| Humana | Commercial | $571.50 | ↑ +50% |
Visitor-reported prices
Comments
Lipoprotein blood high res frac & quant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $361.80 | $27.74 – $64.46 |
| UPMC Jameson | New Castle | $242.40 | $30.51 – $65.60 |
| UPMC Kane | Kane | $134.40 | $30.51 – $146.14 |
| UPMC Passavant-McCandless | Pittsburgh | $188.40 | $30.51 – $65.08 |
| UPMC Presbyterian | Pittsburgh | $539.40 | $27.74 – $65.08 |
| UPMC Williamsport | Williamsport | $325.20 | $30.51 – $36.96 |