healthcosts.net
Screening Colonoscopy (high risk) at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$1,500.00
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.
$2,500.00
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.
$313.61 with Aetna of PA vs $2,715.76 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 |
|---|---|---|---|
| Aetna of PA | Medicare | $313.61 | ↓ -79% |
| UPMC Health Plan | Managed Medicare | $749.61 | ↓ -50% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $869.21 | ↓ -42% |
| Aetna | Medicare | $895.29 | ↓ -40% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $897.20 | ↓ -40% |
| United Healthcare | Medicare | $930.05 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↓ -37% |
| AmeriHealth Caritas | Medicare | $938.75 | ↓ -37% |
| Cigna | Medicare | $938.75 | ↓ -37% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↓ -37% |
| Cigna | EBR | $1,000.00 | ↓ -33% |
| Cigna | Commercial | $1,000.00 | ↓ -33% |
| Aetna | EBR ASO | $1,000.00 | ↓ -33% |
| Aetna | EBR FI | $1,225.00 | ↓ -18% |
| Geisinger | Medicaid/CHIP | $1,375.00 | ↓ -8% |
| United Healthcare | Compass Exchange | $1,375.00 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,375.00 | ↓ -8% |
| Aetna | Neighborhood Network | $1,550.00 | ↑ +3% |
| Aetna | Home Depot Employer Group | $1,592.50 | ↑ +6% |
| Cigna | NBR ASO/FI | $1,625.00 | ↑ +8% |
| Aetna | NBR ASO/FI | $1,625.00 | ↑ +8% |
| Cigna | New Business ASO | $1,625.00 | ↑ +8% |
| United Healthcare | All Business | $1,625.00 | ↑ +8% |
| InterGroup | PPO | $1,625.00 | ↑ +8% |
| Coventry/First Health | Commercial | $1,750.00 | ↑ +17% |
| Preferred Healthcare System | PPO | $2,000.00 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,177.19 | ↑ +45% |
| UPMC Health Plan | CHIP | $2,241.85 | ↑ +49% |
| Health Coalition Partners | Intergroup | $2,250.00 | ↑ +50% |
| Private Health Care Systems | PPO | $2,250.00 | ↑ +50% |
| Humana | Commercial | $2,250.00 | ↑ +50% |
| SelectCare | Commercial | $2,250.00 | ↑ +50% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,682.09 | ↑ +79% |
| UPMC Health Plan | Commercial | $2,715.76 | ↑ +81% |
| Tricare | TRICARE | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Screening Colonoscopy (high risk) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,800.00 | $792.58 – $2,550.00 |
| UPMC Cole | Coudersport | $718.20 | $331.81 – $1,041.88 |
| UPMC Magee | Pittsburgh | $1,500.00 | $450.00 – $2,300.00 |
| UPMC McKeesport | Mckeesport | $1,500.00 | $792.58 – $2,125.00 |
| UPMC Muncy | Muncy | $1,575.00 | $393.75 – $2,362.50 |
| UPMC Presbyterian | Pittsburgh | $1,500.00 | $450.00 – $3,624.67 |
| UPMC Wellsboro | Wellsboro | $2,000.00 | $450.00 – $2,250.00 |
| UPMC East | Monroeville | not published | $792.58 – $956.13 |