Prostate biopsy, any mthd at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$308.40
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.
$514.00
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.
$123.74 with Aetna of PA vs $2,646.15 with Highmark BCBS of PA — 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 | $123.74 | ↓ -60% |
| UPMC Health Plan | Commercial | $129.71 | ↓ -58% |
| Aetna | EBR ASO | $205.60 | ↓ -33% |
| Cigna | EBR | $205.60 | ↓ -33% |
| Cigna | Commercial | $205.60 | ↓ -33% |
| Aetna | EBR FI | $251.86 | ↓ -18% |
| Geisinger | Medicaid/CHIP | $282.70 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $282.70 | ↓ -8% |
| United Healthcare | Compass Exchange | $282.70 | ↓ -8% |
| UPMC Health Plan | Managed Medicare | $295.76 | ↓ -4% |
| Aetna | Neighborhood Network | $318.68 | ↑ +3% |
| Aetna | Home Depot Employer Group | $327.42 | ↑ +6% |
| InterGroup | PPO | $334.10 | ↑ +8% |
| United Healthcare | All Business | $334.10 | ↑ +8% |
| Aetna | NBR ASO/FI | $334.10 | ↑ +8% |
| Cigna | New Business ASO | $334.10 | ↑ +8% |
| Cigna | NBR ASO/FI | $334.10 | ↑ +8% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $342.95 | ↑ +11% |
| Aetna | Medicare | $353.24 | ↑ +15% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $353.99 | ↑ +15% |
| Coventry/First Health | Commercial | $359.80 | ↑ +17% |
| United Healthcare | Medicare | $366.96 | ↑ +19% |
| Highmark Wholecare (prev Gateway) | Medicare | $370.35 | ↑ +20% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $370.39 | ↑ +20% |
| AmeriHealth Caritas | Medicare | $370.39 | ↑ +20% |
| Cigna | Medicare | $370.39 | ↑ +20% |
| Preferred Healthcare System | PPO | $411.20 | ↑ +33% |
| SelectCare | Commercial | $462.60 | ↑ +50% |
| Private Health Care Systems | PPO | $462.60 | ↑ +50% |
| Humana | Commercial | $462.60 | ↑ +50% |
| Health Coalition Partners | Intergroup | $462.60 | ↑ +50% |
| UPMC Health Plan | CHIP | $465.14 | ↑ +51% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,148.02 | ↑ +597% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,646.15 | ↑ +758% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Prostate biopsy, any mthd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $287.40 | $239.50 – $774.58 |
| UPMC Carlisle | Carlisle | $643.20 | $146.86 – $911.20 |
| UPMC Cole | Coudersport | $1,301.40 | $53.00 – $1,735.20 |
| UPMC Community Osteopathic | Harrisburg | $643.20 | $214.40 – $911.20 |
| UPMC East | Monroeville | $308.40 | $127.95 – $781.96 |
| UPMC Hamot | Erie | $334.20 | $157.05 – $774.58 |
| UPMC Northwest | Seneca | $308.40 | $129.14 – $370.39 |
| UPMC Hanover | Hanover | $643.20 | $259.00 – $549.82 |