Pt re-evaluation patient/family at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$125.40
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.
$209.00
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.
$45.28 with United Healthcare Community Plan for Families vs $188.45 with UPMC Health Plan — 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 | $45.28 | ↓ -64% |
| UPMC Health Plan | Managed Medicaid | $47.43 | ↓ -62% |
| United Healthcare Community Plan for Families | Unison Kids | $49.59 | ↓ -60% |
| UPMC Work Partners | Workers Comp | $50.43 | ↓ -60% |
| Aetna | Medicare | $52.25 | ↓ -58% |
| Aetna | Medicaid | $53.90 | ↓ -57% |
| Geisinger | Medicaid/CHIP | $59.93 | ↓ -52% |
| Highmark Wholecare (prev Gateway) | Medicaid | $63.95 | ↓ -49% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $65.02 | ↓ -48% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $67.31 | ↓ -46% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $73.49 | ↓ -41% |
| Aetna | EBR ASO | $83.60 | ↓ -33% |
| Cigna | EBR | $83.60 | ↓ -33% |
| Cigna | Commercial | $83.60 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $96.91 | ↓ -23% |
| Aetna | EBR FI | $102.41 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $104.50 | ↓ -17% |
| United Healthcare | Compass Exchange | $114.95 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $119.38 | ↓ -5% |
| Aetna | Neighborhood Network | $129.58 | ↑ +3% |
| Aetna | Home Depot Employer Group | $133.13 | ↑ +6% |
| Cigna | NBR ASO/FI | $135.85 | ↑ +8% |
| United Healthcare | All Business | $135.85 | ↑ +8% |
| Aetna | NBR ASO/FI | $135.85 | ↑ +8% |
| Cigna | New Business ASO | $135.85 | ↑ +8% |
| InterGroup | PPO | $135.85 | ↑ +8% |
| Coventry/First Health | Commercial | $146.30 | ↑ +17% |
| UPMC Health Plan | CHIP | $155.57 | ↑ +24% |
| Preferred Healthcare System | PPO | $167.20 | ↑ +33% |
| Private Health Care Systems | PPO | $188.10 | ↑ +50% |
| Health Coalition Partners | Intergroup | $188.10 | ↑ +50% |
| Humana | Commercial | $188.10 | ↑ +50% |
| SelectCare | Commercial | $188.10 | ↑ +50% |
| UPMC Health Plan | Commercial | $188.45 | ↑ +50% |
Visitor-reported prices
Comments
Pt re-evaluation patient/family at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $113.40 | $34.95 – $151.20 |
| UPMC Carlisle | Carlisle | $139.20 | $31.78 – $387.00 |
| UPMC Cole | Coudersport | $125.40 | $43.98 – $167.20 |
| UPMC Community Osteopathic | Harrisburg | $139.20 | $46.40 – $197.20 |
| UPMC East | Monroeville | $155.40 | $35.28 – $207.20 |
| UPMC Hamot | Erie | $121.20 | $34.95 – $121.18 |
| UPMC Northwest | Seneca | $105.00 | $47.43 – $90.70 |
| UPMC Hanover | Hanover | $139.20 | $52.78 – $148.00 |