Sigmoidoscopy/submucosal injection 45335 at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$4,209.00
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.
$7,015.00
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.
$82.58 with United Healthcare Community Plan for Families vs $6,313.50 with Health Coalition Partners — 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 | $82.58 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $86.52 | ↓ -98% |
| United Healthcare Community Plan for Families | Unison Kids | $90.45 | ↓ -98% |
| Aetna | Medicaid | $98.31 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $109.32 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $116.64 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $118.60 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $122.78 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $134.04 | ↓ -97% |
| UPMC Work Partners | Workers Comp | $264.33 | ↓ -94% |
| Aetna of PA | Medicare | $313.61 | ↓ -93% |
| UPMC Health Plan | Managed Medicare | $749.61 | ↓ -82% |
| 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 | ↓ -79% |
| Aetna | Medicare | $895.29 | ↓ -79% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $897.20 | ↓ -79% |
| UPMC Health Plan | Commercial | $913.82 | ↓ -78% |
| United Healthcare | Medicare | $930.05 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.66 | ↓ -78% |
| AmeriHealth Caritas | Medicare | $938.75 | ↓ -78% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.75 | ↓ -78% |
| Cigna | Medicare | $938.75 | ↓ -78% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $1,625.59 | ↓ -61% |
| UPMC Health Plan | CHIP | $1,656.82 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $2,002.57 | ↓ -52% |
| Cigna | EBR | $2,806.00 | ↓ -33% |
| Cigna | Commercial | $2,806.00 | ↓ -33% |
| Aetna | EBR ASO | $2,806.00 | ↓ -33% |
| Aetna | EBR FI | $3,437.35 | ↓ -18% |
| United Healthcare | Compass Exchange | $3,858.25 | ↓ -8% |
| Aetna | Neighborhood Network | $4,349.30 | ↑ +3% |
| Aetna | Home Depot Employer Group | $4,468.56 | ↑ +6% |
| Aetna | NBR ASO/FI | $4,559.75 | ↑ +8% |
| United Healthcare | All Business | $4,559.75 | ↑ +8% |
| InterGroup | PPO | $4,559.75 | ↑ +8% |
| Cigna | New Business ASO | $4,559.75 | ↑ +8% |
| Cigna | NBR ASO/FI | $4,559.75 | ↑ +8% |
| Coventry/First Health | Commercial | $4,910.50 | ↑ +17% |
| Preferred Healthcare System | PPO | $5,612.00 | ↑ +33% |
| Humana | Commercial | $6,313.50 | ↑ +50% |
| SelectCare | Commercial | $6,313.50 | ↑ +50% |
| Private Health Care Systems | PPO | $6,313.50 | ↑ +50% |
| Health Coalition Partners | Intergroup | $6,313.50 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Sigmoidoscopy/submucosal injection 45335 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,459.20 | $78.65 – $1,945.60 |
| UPMC Cole | Coudersport | $180.60 | $82.58 – $771.51 |
| UPMC East | Monroeville | $2,976.60 | $86.52 – $3,968.80 |
| UPMC Hamot | Erie | $1,558.80 | $86.52 – $1,264.19 |
| UPMC Horizon-Greenville | Greenville | $2,907.00 | $86.52 – $1,140.40 |
| UPMC Jameson | New Castle | $2,907.00 | $86.52 – $1,173.43 |
| UPMC Magee | Pittsburgh | $2,232.00 | $86.52 – $938.75 |
| UPMC McKeesport | Mckeesport | $2,889.00 | $86.52 – $956.13 |