Pr moderate sedation same physician >= 5 years initial 15 minutes at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$138.00
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.
$230.00
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.
$10.39 with United Healthcare Community Plan for Families vs $207.00 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | Unison MedPLUS | $10.39 | ↓ -92% |
| UPMC Health Plan | Managed Medicaid | $10.89 | ↓ -92% |
| United Healthcare Community Plan for Families | Unison Kids | $11.38 | ↓ -92% |
| Aetna | Medicaid | $12.38 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $13.76 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.68 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $14.93 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.45 | ↓ -89% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $16.87 | ↓ -88% |
| Aetna | Medicare | $57.50 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $64.78 | ↓ -53% |
| UPMC Health Plan | CHIP | $80.50 | ↓ -42% |
| Aetna | EBR ASO | $92.00 | ↓ -33% |
| Cigna | Commercial | $92.00 | ↓ -33% |
| Cigna | EBR | $92.00 | ↓ -33% |
| Aetna | EBR FI | $112.70 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $115.00 | ↓ -17% |
| United Healthcare | Compass Exchange | $126.50 | ↓ -8% |
| Aetna | Neighborhood Network | $142.60 | ↑ +3% |
| Aetna | Home Depot Employer Group | $146.51 | ↑ +6% |
| Cigna | NBR ASO/FI | $149.50 | ↑ +8% |
| United Healthcare | All Business | $149.50 | ↑ +8% |
| Aetna | NBR ASO/FI | $149.50 | ↑ +8% |
| Cigna | New Business ASO | $149.50 | ↑ +8% |
| InterGroup | PPO | $149.50 | ↑ +8% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $158.70 | ↑ +15% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $158.70 | ↑ +15% |
| Coventry/First Health | Commercial | $161.00 | ↑ +17% |
| UPMC Health Plan | Commercial | $163.76 | ↑ +19% |
| Preferred Healthcare System | PPO | $184.00 | ↑ +33% |
| SelectCare | Commercial | $207.00 | ↑ +50% |
| Health Coalition Partners | Intergroup | $207.00 | ↑ +50% |
| Private Health Care Systems | PPO | $207.00 | ↑ +50% |
| Humana | Commercial | $207.00 | ↑ +50% |
Visitor-reported prices
Comments
Pr moderate sedation same physician >= 5 years initial 15 minutes at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $223.20 | $9.90 – $297.60 |
| UPMC Carlisle | Carlisle | $831.60 | $12.57 – $1,178.10 |
| UPMC Cole | Coudersport | $21.00 | $9.70 – $64.78 |
| UPMC Community Osteopathic | Harrisburg | $831.60 | $12.57 – $1,178.10 |
| UPMC East | Monroeville | $377.40 | $10.89 – $503.20 |
| UPMC Hamot | Erie | $725.40 | $10.89 – $64.78 |
| UPMC Northwest | Seneca | $138.00 | $10.89 – $64.78 |
| UPMC Hanover | Hanover | $831.60 | $12.57 – $67.79 |