healthcosts.net
New Patient Office Visit (level 2) at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$216.00
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.
$360.00
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.
$36.08 with Aetna of PA vs $324.00 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 | $36.08 | ↓ -83% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $37.10 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $38.86 | ↓ -82% |
| United Healthcare Community Plan for Families | Unison Kids | $40.63 | ↓ -81% |
| Aetna | Medicaid | $44.16 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $49.11 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $52.39 | ↓ -76% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $53.28 | ↓ -75% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $55.15 | ↓ -74% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $60.21 | ↓ -72% |
| Cigna | New Business ASO | $63.91 | ↓ -70% |
| Cigna | Commercial | $63.91 | ↓ -70% |
| Aetna | Medicare | $90.00 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $100.71 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $130.05 | ↓ -40% |
| Cigna | EBR | $144.00 | ↓ -33% |
| Aetna | EBR ASO | $144.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $160.21 | ↓ -26% |
| Aetna | EBR FI | $176.40 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $180.00 | ↓ -17% |
| United Healthcare | Compass Exchange | $198.00 | ↓ -8% |
| Aetna | Neighborhood Network | $223.20 | ↑ +3% |
| Aetna | Home Depot Employer Group | $229.32 | ↑ +6% |
| Cigna | NBR ASO/FI | $234.00 | ↑ +8% |
| Aetna | NBR ASO/FI | $234.00 | ↑ +8% |
| United Healthcare | All Business | $234.00 | ↑ +8% |
| InterGroup | PPO | $234.00 | ↑ +8% |
| UPMC Health Plan | CHIP | $238.45 | ↑ +10% |
| Coventry/First Health | Commercial | $252.00 | ↑ +17% |
| Preferred Healthcare System | PPO | $288.00 | ↑ +33% |
| Health Coalition Partners | Intergroup | $324.00 | ↑ +50% |
| Private Health Care Systems | PPO | $324.00 | ↑ +50% |
| Humana | Commercial | $324.00 | ↑ +50% |
| SelectCare | Commercial | $324.00 | ↑ +50% |
Visitor-reported prices
Comments
New Patient Office Visit (level 2) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $255.60 | $36.08 – $340.80 |
| UPMC Passavant-McCandless | Pittsburgh | $183.60 | $38.86 – $260.10 |
| UPMC Hamot | Erie | $180.00 | $38.86 – $210.00 |
| UPMC Altoona | Altoona | $207.00 | $20.00 – $276.00 |
| UPMC Cole | Coudersport | $183.00 | $37.10 – $140.00 |
| UPMC Community Osteopathic | Harrisburg | $214.80 | $19.80 – $397.63 |
| UPMC Hanover | Hanover | $59.40 | $18.81 – $105.40 |
| UPMC Horizon-Greenville | Greenville | $260.40 | $37.10 – $368.90 |