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Vaccine pneumococcal conjugate 13 valent (pcv13) im at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$144.00
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.
$240.00
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.
$10.50 with United Healthcare Community Plan for Families vs $786.33 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 | $10.50 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $11.00 | ↓ -92% |
| United Healthcare Community Plan for Families | Unison Kids | $11.50 | ↓ -92% |
| Aetna | Medicaid | $12.50 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $13.90 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $15.08 | ↓ -90% |
| Aetna | Medicare | $60.00 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $69.70 | ↓ -52% |
| Aetna | EBR ASO | $96.00 | ↓ -33% |
| Cigna | Commercial | $96.00 | ↓ -33% |
| Cigna | EBR | $96.00 | ↓ -33% |
| Aetna | EBR FI | $117.60 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $120.00 | ↓ -17% |
| United Healthcare | Compass Exchange | $136.80 | ↓ -5% |
| Aetna | Neighborhood Network | $148.80 | ↑ +3% |
| Aetna | Home Depot Employer Group | $152.88 | ↑ +6% |
| Cigna | New Business ASO | $156.00 | ↑ +8% |
| Cigna | NBR ASO/FI | $156.00 | ↑ +8% |
| InterGroup | PPO | $156.00 | ↑ +8% |
| Aetna | NBR ASO/FI | $156.00 | ↑ +8% |
| United Healthcare | All Business | $160.80 | ↑ +12% |
| Coventry/First Health | Commercial | $168.00 | ↑ +17% |
| Preferred Healthcare System | PPO | $192.00 | ↑ +33% |
| Humana | Commercial | $216.00 | ↑ +50% |
| Private Health Care Systems | PPO | $216.00 | ↑ +50% |
| SelectCare | Commercial | $216.00 | ↑ +50% |
| Health Coalition Partners | Intergroup | $216.00 | ↑ +50% |
| Highmark Wholecare (prev Gateway) | Medicaid | $257.99 | ↑ +79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $257.99 | ↑ +79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $257.99 | ↑ +79% |
| UPMC Health Plan | CHIP | $299.36 | ↑ +108% |
| UPMC Health Plan | Commercial | $317.33 | ↑ +120% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $638.31 | ↑ +343% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $786.33 | ↑ +446% |
Visitor-reported prices
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Vaccine pneumococcal conjugate 13 valent (pcv13) im at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $144.00 | $10.00 – $773.97 |
| UPMC Northwest | Seneca | $144.00 | $11.00 – $597.39 |
| UPMC Mercy | Pittsburgh | $144.00 | $11.00 – $257.99 |
| UPMC Muncy | Muncy | $144.00 | $11.00 – $216.00 |
| UPMC Passavant-McCandless | Pittsburgh | $144.00 | $11.00 – $257.99 |
| UPMC Presbyterian | Pittsburgh | $144.00 | $11.00 – $257.99 |
| UPMC St. Margaret | Pittsburgh | $144.00 | $11.00 – $257.99 |
| UPMC Wellsboro | Wellsboro | $144.00 | $11.00 – $216.00 |