Tympanic membrane repair at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
not published by hospital
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.
not published by hospital
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.
$87.15 with United Healthcare Community Plan for Families vs $5,573.36 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | Unison MedPLUS | $87.15 | — |
| UPMC Health Plan | Managed Medicaid | $91.30 | — |
| United Healthcare Community Plan for Families | Unison Kids | $95.45 | — |
| Aetna | Medicaid | $103.75 | — |
| Geisinger | Medicaid/CHIP | $115.36 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $123.09 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $125.16 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $129.57 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $141.45 | — |
| UPMC Work Partners | Workers Comp | $414.95 | — |
| Aetna of PA | Medicare | $509.53 | — |
| UPMC Health Plan | Managed Medicare | $1,217.90 | — |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $1,412.22 | — |
| Aetna | Medicare | $1,454.59 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,457.69 | — |
| United Healthcare | Medicare | $1,511.08 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $1,525.06 | — |
| Cigna | Medicare | $1,525.20 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,525.20 | — |
| AmeriHealth Caritas | Medicare | $1,525.20 | — |
| UPMC Health Plan | Commercial | $2,850.72 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $4,524.18 | — |
| UPMC Health Plan | CHIP | $5,168.52 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $5,573.36 | — |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Tympanic membrane repair at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $549.60 | $78.72 – $2,325.85 |
| UPMC Magee | Pittsburgh | $6,809.40 | $91.30 – $1,646.97 |
| UPMC Passavant-McCandless | Pittsburgh | $8,426.40 | $91.30 – $1,646.97 |
| Uniontown Hospital | Uniontown | $1,783.50 | $91.30 – $3,123.56 |
| UPMC Altoona | Altoona | not published | $83.00 – $1,631.43 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $10,638.00 – $10,638.00 |
| WellSpan Gettysburg Hospital | Gettysburg | not published | $970.00 – $1,101.92 |