Mayo nickel at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$321.00
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.
$535.00
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.
$8.84 with Aetna of PA vs $481.50 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 | $8.84 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $11.00 | ↓ -97% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $11.55 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $12.10 | ↓ -96% |
| United Healthcare Community Plan for Families | Unison Kids | $12.65 | ↓ -96% |
| Aetna | Medicaid | $13.75 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $15.29 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $16.31 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $17.17 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $18.75 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $21.14 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $24.23 | ↓ -92% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $24.51 | ↓ -92% |
| Aetna | Medicare | $25.25 | ↓ -92% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $25.30 | ↓ -92% |
| United Healthcare | Medicare | $26.23 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $26.47 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $26.47 | ↓ -92% |
| Cigna | Medicare | $26.47 | ↓ -92% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $26.47 | ↓ -92% |
| UPMC Health Plan | Commercial | $39.45 | ↓ -88% |
| UPMC Health Plan | CHIP | $141.46 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $142.01 | ↓ -56% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $174.95 | ↓ -45% |
| Cigna | EBR | $214.00 | ↓ -33% |
| Aetna | EBR ASO | $214.00 | ↓ -33% |
| Cigna | Commercial | $214.00 | ↓ -33% |
| Aetna | EBR FI | $262.15 | ↓ -18% |
| United Healthcare | Compass Exchange | $294.25 | ↓ -8% |
| Aetna | Neighborhood Network | $331.70 | ↑ +3% |
| Aetna | Home Depot Employer Group | $340.80 | ↑ +6% |
| Cigna | NBR ASO/FI | $347.75 | ↑ +8% |
| Aetna | NBR ASO/FI | $347.75 | ↑ +8% |
| United Healthcare | All Business | $347.75 | ↑ +8% |
| InterGroup | PPO | $347.75 | ↑ +8% |
| Cigna | New Business ASO | $347.75 | ↑ +8% |
| Coventry/First Health | Commercial | $374.50 | ↑ +17% |
| Preferred Healthcare System | PPO | $428.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $481.50 | ↑ +50% |
| SelectCare | Commercial | $481.50 | ↑ +50% |
| Private Health Care Systems | PPO | $481.50 | ↑ +50% |
| Humana | Commercial | $481.50 | ↑ +50% |
Visitor-reported prices
Comments
Mayo nickel at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $253.20 | $11.00 – $337.60 |
| UPMC Carlisle | Carlisle | $89.40 | $11.00 – $126.65 |
| UPMC Community Osteopathic | Harrisburg | $89.40 | $11.00 – $141.46 |
| UPMC Northwest | Seneca | $175.20 | $12.10 – $25.74 |
| UPMC Hanover | Hanover | $89.40 | $11.00 – $39.22 |
| UPMC Horizon-Greenville | Greenville | $179.40 | $11.00 – $45.99 |
| UPMC Jameson | New Castle | $179.40 | $12.10 – $52.11 |
| UPMC Kane | Kane | $146.40 | $12.10 – $105.79 |