Surgical pathology level 5 gross & microscopic examination at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$189.60
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.
?
What you pay up front if you don't use insurance.
$316.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$36.42 with UPMC Health Plan vs $370.39 with Cigna — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $36.42 | ↓ -81% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $45.50 | ↓ -76% |
| United Healthcare Community Plan for Families | Unison MedPLUS | $47.77 | ↓ -75% |
| UPMC Health Plan | Managed Medicaid | $50.05 | ↓ -74% |
| United Healthcare Community Plan for Families | Unison Kids | $52.33 | ↓ -72% |
| Aetna | Medicaid | $56.88 | ↓ -70% |
| Geisinger | Medicaid/CHIP | $63.24 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicaid | $67.48 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $71.03 | ↓ -63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $77.54 | ↓ -59% |
| Aetna of PA | Medicare | $123.74 | ↓ -35% |
| Cigna | EBR | $126.40 | ↓ -33% |
| Aetna | EBR ASO | $126.40 | ↓ -33% |
| Cigna | Commercial | $126.40 | ↓ -33% |
| UPMC Health Plan | CHIP | $130.59 | ↓ -31% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $136.03 | ↓ -28% |
| Aetna | EBR FI | $154.84 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $167.58 | ↓ -12% |
| United Healthcare | Compass Exchange | $173.80 | ↓ -8% |
| Aetna | Neighborhood Network | $195.92 | ↑ +3% |
| Aetna | Home Depot Employer Group | $201.29 | ↑ +6% |
| United Healthcare | All Business | $205.40 | ↑ +8% |
| InterGroup | PPO | $205.40 | ↑ +8% |
| Cigna | New Business ASO | $205.40 | ↑ +8% |
| Cigna | NBR ASO/FI | $205.40 | ↑ +8% |
| Aetna | NBR ASO/FI | $205.40 | ↑ +8% |
| Coventry/First Health | Commercial | $221.20 | ↑ +17% |
| UPMC Work Partners | Workers Comp | $251.07 | ↑ +32% |
| Preferred Healthcare System | PPO | $252.80 | ↑ +33% |
| SelectCare | Commercial | $284.40 | ↑ +50% |
| Humana | Commercial | $284.40 | ↑ +50% |
| Health Coalition Partners | Intergroup | $284.40 | ↑ +50% |
| Private Health Care Systems | PPO | $284.40 | ↑ +50% |
| UPMC Health Plan | Managed Medicare | $295.76 | ↑ +56% |
| 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 | ↑ +81% |
| Aetna | Medicare | $353.24 | ↑ +86% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $353.99 | ↑ +87% |
| United Healthcare | Medicare | $366.96 | ↑ +94% |
| Highmark Wholecare (prev Gateway) | Medicare | $370.35 | ↑ +95% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $370.39 | ↑ +95% |
| AmeriHealth Caritas | Medicare | $370.39 | ↑ +95% |
| Cigna | Medicare | $370.39 | ↑ +95% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $234.60 | $11.50 – $312.80 |
| UPMC Carlisle | Carlisle | $664.80 | $15.06 – $941.80 |
| UPMC Cole | Coudersport | $572.40 | $47.77 – $763.20 |
| UPMC Community Osteopathic | Harrisburg | $664.80 | $15.06 – $378.62 |
| UPMC East | Monroeville | $379.20 | $35.92 – $505.60 |
| UPMC Hamot | Erie | $360.60 | $45.50 – $427.47 |
| UPMC Northwest | Seneca | $360.60 | $36.26 – $360.10 |
| UPMC Hanover | Hanover | $664.80 | $15.06 – $549.82 |