X-ray exam of eye sockets at UPMC Bedford
10455 Lincoln Highway, Everett, PA · UPMC · · NPI 1295724193
$141.00
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.
$235.00
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.
$35.55 with United Healthcare Community Plan for Families vs $211.50 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 | $35.55 | ↓ -75% |
| Aetna of PA | Medicare | $36.58 | ↓ -74% |
| UPMC Health Plan | Managed Medicaid | $37.25 | ↓ -74% |
| United Healthcare Community Plan for Families | Unison Kids | $38.94 | ↓ -72% |
| Aetna | Medicaid | $42.33 | ↓ -70% |
| UPMC Health Plan | Commercial | $43.88 | ↓ -69% |
| Geisinger | Medicaid/CHIP | $47.06 | ↓ -67% |
| Highmark Wholecare (prev Gateway) | Medicaid | $50.21 | ↓ -64% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $51.06 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $52.86 | ↓ -63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $57.70 | ↓ -59% |
| UPMC Health Plan | Managed Medicare | $87.43 | ↓ -38% |
| Aetna | EBR ASO | $94.00 | ↓ -33% |
| Cigna | EBR | $94.00 | ↓ -33% |
| Cigna | Commercial | $94.00 | ↓ -33% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage/Together Blue Medicare Advantage | $101.38 | ↓ -28% |
| UPMC Work Partners | Workers Comp | $102.91 | ↓ -27% |
| Aetna | Medicare | $104.42 | ↓ -26% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $104.64 | ↓ -26% |
| United Healthcare | Medicare | $108.48 | ↓ -23% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -22% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $109.49 | ↓ -22% |
| AmeriHealth Caritas | Medicare | $109.49 | ↓ -22% |
| Cigna | Medicare | $109.49 | ↓ -22% |
| Aetna | EBR FI | $115.15 | ↓ -18% |
| United Healthcare | Compass Exchange | $129.25 | ↓ -8% |
| Aetna | Neighborhood Network | $145.70 | ↑ +3% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $145.88 | ↑ +3% |
| Aetna | Home Depot Employer Group | $149.69 | ↑ +6% |
| Aetna | NBR ASO/FI | $152.75 | ↑ +8% |
| InterGroup | PPO | $152.75 | ↑ +8% |
| United Healthcare | All Business | $152.75 | ↑ +8% |
| Cigna | New Business ASO | $152.75 | ↑ +8% |
| Cigna | NBR ASO/FI | $152.75 | ↑ +8% |
| UPMC Health Plan | CHIP | $157.36 | ↑ +12% |
| Coventry/First Health | Commercial | $164.50 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $179.71 | ↑ +27% |
| Preferred Healthcare System | PPO | $188.00 | ↑ +33% |
| SelectCare | Commercial | $211.50 | ↑ +50% |
| Private Health Care Systems | PPO | $211.50 | ↑ +50% |
| Humana | Commercial | $211.50 | ↑ +50% |
| Health Coalition Partners | Intergroup | $211.50 | ↑ +50% |
| Tricare | TRICARE | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
X-ray exam of eye sockets at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $111.00 | $21.00 – $148.00 |
| UPMC Carlisle | Carlisle | $262.80 | $27.51 – $372.30 |
| UPMC Cole | Coudersport | $170.40 | $35.55 – $227.20 |
| UPMC Community Osteopathic | Harrisburg | $262.80 | $27.51 – $372.30 |
| UPMC East | Monroeville | $436.20 | $37.25 – $581.60 |
| UPMC Hamot | Erie | $340.20 | $32.52 – $166.40 |
| UPMC Northwest | Seneca | $194.40 | $37.25 – $106.45 |
| UPMC Hanover | Hanover | $262.80 | $27.51 – $162.54 |