healthcosts.net
Ultrasound breast unilateral limited (both sides) at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$291.00
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.
$485.00
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.
$30.29 with Aetna of PA vs $436.50 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 |
|---|---|---|---|
| Aetna of PA | Medicare | $30.29 | ↓ -90% |
| UPMC Health Plan | Commercial | $54.77 | ↓ -81% |
| UPMC Health Plan | Managed Medicare | $72.40 | ↓ -75% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $83.95 | ↓ -71% |
| Aetna | Medicare | $86.47 | ↓ -70% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $86.65 | ↓ -70% |
| United Healthcare | Medicare | $89.83 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicare | $90.66 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $90.67 | ↓ -69% |
| Cigna | Medicare | $90.67 | ↓ -69% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $90.67 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $95.93 | ↓ -67% |
| UPMC Work Partners | Workers Comp | $116.07 | ↓ -60% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $118.18 | ↓ -59% |
| Aetna | EBR ASO | $194.00 | ↓ -33% |
| Cigna | Commercial | $194.00 | ↓ -33% |
| Cigna | EBR | $194.00 | ↓ -33% |
| UPMC Health Plan | CHIP | $196.39 | ↓ -33% |
| Aetna | EBR FI | $237.65 | ↓ -18% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $266.75 | ↓ -8% |
| United Healthcare | Compass Exchange | $266.75 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $266.75 | ↓ -8% |
| Aetna | Neighborhood Network | $300.70 | ↑ +3% |
| Aetna | Home Depot Employer Group | $308.94 | ↑ +6% |
| Cigna | NBR ASO/FI | $315.25 | ↑ +8% |
| Aetna | NBR ASO/FI | $315.25 | ↑ +8% |
| Cigna | New Business ASO | $315.25 | ↑ +8% |
| United Healthcare | All Business | $315.25 | ↑ +8% |
| InterGroup | PPO | $315.25 | ↑ +8% |
| Coventry/First Health | Commercial | $339.50 | ↑ +17% |
| Preferred Healthcare System | PPO | $388.00 | ↑ +33% |
| Humana | Commercial | $436.50 | ↑ +50% |
| SelectCare | Commercial | $436.50 | ↑ +50% |
| Private Health Care Systems | PPO | $436.50 | ↑ +50% |
| Health Coalition Partners | Intergroup | $436.50 | ↑ +50% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | TRICARE | not published by hospital | — |
Visitor-reported prices
Comments
Ultrasound breast unilateral limited (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $253.80 | $34.59 – $338.40 |
| UPMC Carlisle | Carlisle | $280.20 | $16.44 – $134.77 |
| UPMC Northwest | Seneca | $400.20 | $54.53 – $566.95 |
| UPMC Mercy | Pittsburgh | $370.80 | $34.59 – $556.20 |
| UPMC Muncy | Muncy | $479.40 | $52.40 – $639.20 |
| UPMC Passavant-McCandless | Pittsburgh | $894.00 | $34.92 – $1,266.50 |
| UPMC Presbyterian | Pittsburgh | $1,187.40 | $34.92 – $1,682.15 |
| UPMC Somerset | Somerset | $372.60 | $34.24 – $116.07 |