▸ Hospital · PA · CCN 390117
UPMC Bedford
10455 LINCOLN HIGHWAY, EVERETT, PA, 15537
35 bedsAcute Care Hospitals2
Compliance grade
A
100/100
Procedures tracked
154
of 209 target codes
Payers
17
with negotiated rates
Rates published
40,586
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 7 | — | — | $7,821.24 | $11,123 | $12,388 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 16 | $359 | $215.4 | $30.29 | $222.58 | $323.1 |
| ED visit level 2 | CPT | 99282 | 17 | $542 | $325.2 | $34.63 | $290.91 | $487.8 |
| ED visit level 3 | CPT | 99283 | 17 | $716 | $429.6 | $59.48 | $387.72 | $644.4 |
| ED visit level 4 | CPT | 99284 | 17 | $1,076 | $645.6 | $100.1 | $559.52 | $968.4 |
| ED visit level 5 | CPT | 99285 | 17 | $1,506 | $903.6 | $145.68 | $783.12 | $1,355.4 |
| Critical care, first hour | CPT | 99291 | 17 | $1,813 | $1,087.8 | $159.21 | $942.76 | $1,631.7 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 17 | $1,235 | $741 | $36.58 | $739.89 | $1,111.5 |
| CT head with contrast | CPT | 70460 | 17 | $1,456 | $873.6 | $61.23 | $882.58 | $1,310.4 |
| CT head with and without contrast | CPT | 70470 | 17 | $1,596 | $957.6 | $61.23 | $989.52 | $1,436.4 |
| CT neck with contrast | CPT | 70491 | 17 | $1,413 | $847.8 | $61.23 | $876.06 | $1,271.7 |
| MRI brain without contrast | CPT | 70551 | 17 | $2,842 | $1,705.2 | $83.15 | $1,690.99 | $2,557.8 |
| MRI brain with contrast | CPT | 70552 | 17 | $7,611 | $4,566.6 | $122.85 | $3,957.72 | $6,849.9 |
| MRI brain with and without contrast | CPT | 70553 | 17 | $4,807 | $2,884.2 | $122.85 | $2,980.34 | $4,326.3 |
| Chest X-ray single view | CPT | 71045 | 17 | $167 | $100.2 | $16.25 | $93.52 | $150.3 |
| Chest X-ray 2 views | CPT | 71046 | 17 | $193 | $115.8 | $24.82 | $108.08 | $173.7 |
| Chest X-ray 3 views | CPT | 71047 | 17 | $209 | $125.4 | $30.29 | $117.04 | $227.64 |
| CT chest without contrast | CPT | 71250 | 17 | $1,413 | $847.8 | $36.58 | $876.06 | $1,271.7 |
| CT chest with contrast | CPT | 71260 | 17 | $1,596 | $957.6 | $61.23 | $989.52 | $1,436.4 |
| CT chest with and without contrast | CPT | 71270 | 17 | $1,804 | $1,082.4 | $61.23 | $1,118.48 | $1,623.6 |
| MRI chest without contrast | CPT | 71550 | 17 | $6,010 | $3,606 | $83.15 | $3,125.2 | $5,409 |
| MRI chest with and without contrast | CPT | 71552 | 17 | $10,898 | $6,538.8 | $122.85 | $5,666.96 | $9,808.2 |
| Lumbosacral spine X-ray | CPT | 72100 | 17 | $193 | $115.8 | $34.16 | $119.03 | $173.7 |
| CT cervical spine without contrast | CPT | 72125 | 17 | $1,413 | $847.8 | $36.58 | $876.06 | $1,271.7 |
| CT thoracic spine without contrast | CPT | 72128 | 17 | $1,413 | $847.8 | $36.58 | $876.06 | $1,271.7 |
| CT lumbar spine without contrast | CPT | 72131 | 17 | $1,413 | $847.8 | $36.58 | $876.06 | $1,271.7 |
| MRI cervical spine without contrast | CPT | 72141 | 17 | $2,842 | $1,705.2 | $83.15 | $1,690.99 | $2,557.8 |
| MRI thoracic spine without contrast | CPT | 72146 | 17 | $2,842 | $1,705.2 | $83.15 | $1,750.9 | $2,557.8 |
| MRI lumbar spine without contrast | CPT | 72148 | 17 | $2,842 | $1,705.2 | $83.15 | $1,739.98 | $2,557.8 |
| MRI lumbar spine with and without contrast | CPT | 72149 | 17 | $6,696 | $4,017.6 | $122.85 | $3,481.92 | $6,026.4 |
| MRI cervical spine with and without contrast | CPT | 72156 | 17 | $4,860 | $2,916 | $122.85 | $3,013.2 | $4,374 |
| MRI lumbar spine with contrast | CPT | 72158 | 17 | $4,807 | $2,884.2 | $122.85 | $2,980.34 | $4,326.3 |
| CT pelvis without contrast | CPT | 72192 | 17 | $1,413 | $847.8 | $36.58 | $876.06 | $1,271.7 |
| CT pelvis with contrast | CPT | 72193 | 17 | $1,596 | $957.6 | $61.23 | $989.52 | $1,436.4 |
| Shoulder X-ray | CPT | 73030 | 16 | $213 | $127.8 | $28.72 | $132.06 | $191.7 |
| Humerus X-ray | CPT | 73060 | 16 | $180 | $108 | $28.14 | $114.66 | $162 |
| Hand X-ray 3 views | CPT | 73130 | 16 | $193 | $115.8 | $26.89 | $119.66 | $173.7 |
| MRI upper extremity joint without contrast | CPT | 73221 | 16 | $2,842 | $1,705.2 | $83.15 | $1,810.35 | $2,557.8 |
| MRI upper extremity joint with and without contrast | CPT | 73223 | 16 | $4,272 | $2,563.2 | $122.85 | $2,734.08 | $3,844.8 |
| Knee X-ray 1-2 views | CPT | 73560 | 16 | $180 | $108 | $30.29 | $111.6 | $162 |
| Ankle X-ray 3 views | CPT | 73610 | 16 | $180 | $108 | $26.38 | $113.73 | $162 |
| MRI lower extremity joint without contrast | CPT | 73721 | 16 | $2,842 | $1,705.2 | $83.15 | $1,810.35 | $2,557.8 |
| MRI lower extremity joint with and without contrast | CPT | 73723 | 16 | $4,272 | $2,563.2 | $122.85 | $2,734.08 | $3,844.8 |
| CT abdomen without contrast | CPT | 74150 | 17 | $1,413 | $847.8 | $36.58 | $873.76 | $1,271.7 |
| CT abdomen with contrast | CPT | 74160 | 17 | $1,596 | $957.6 | $61.23 | $989.52 | $1,436.4 |
| CT abdomen with and without contrast | CPT | 74170 | 17 | $1,804 | $1,082.4 | $61.23 | $1,118.48 | $1,623.6 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 17 | $2,834 | $1,700.4 | $83.15 | $1,618.16 | $2,682.79 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 17 | $3,192 | $1,915.2 | $122.85 | $1,846.87 | $3,952.42 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 17 | $3,611 | $2,166.6 | $122.85 | $2,148.55 | $4,601.97 |
| MRI abdomen without contrast | CPT | 74181 | 17 | $2,842 | $1,705.2 | $83.15 | $1,690.99 | $2,557.8 |
| MRI abdomen with and without contrast | CPT | 74183 | 17 | $4,272 | $2,563.2 | $122.85 | $2,541.84 | $3,844.8 |
| Abdominal ultrasound complete | CPT | 76700 | 17 | $1,097 | $658.2 | $36.58 | $570.44 | $987.3 |
| Abdominal ultrasound limited | CPT | 76705 | 17 | $485 | $291 | $36.58 | $287.86 | $436.5 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 17 | $1,348 | $808.8 | $36.58 | $700.96 | $1,213.2 |
| Obstetric ultrasound first trimester | CPT | 76801 | 17 | $694 | $416.4 | $36.58 | $412.93 | $624.6 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 17 | $694 | $416.4 | $36.58 | $425.45 | $624.6 |
| Obstetric ultrasound with fetal anatomy | CPT | 76811 | 17 | $3,761 | $2,256.6 | $83.15 | $1,955.72 | $3,384.9 |
| Transvaginal ultrasound | CPT | 76830 | 17 | $499 | $299.4 | $36.58 | $305.62 | $449.1 |
| Pelvic ultrasound complete | CPT | 76856 | 17 | $499 | $299.4 | $36.58 | $305.62 | $449.1 |
| Scrotal ultrasound | CPT | 76870 | 17 | $499 | $299.4 | $36.58 | $300.34 | $449.1 |
| Diagnostic mammography unilateral | CPT | 77065 | 16 | $837 | $502.2 | $107.53 | $533.17 | $753.3 |
| Diagnostic mammography bilateral | CPT | 77066 | 16 | $1,015 | $609 | $136.34 | $649.6 | $913.5 |
| Screening mammography bilateral | CPT | 77067 | 16 | $342 | $205.2 | $85.5 | $222.3 | $551.43 |
| EKG tracing only | CPT | 93005 | 17 | $167 | $100.2 | $10.98 | $86.84 | $150.3 |
| Transthoracic echocardiogram complete | CPT | 93306 | 17 | $3,127 | $1,876.2 | $148.07 | $1,626.04 | $2,814.3 |
| Stress echocardiogram | CPT | 93350 | 17 | $1,610 | $966 | $80.33 | $901.6 | $1,449 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 8 | — | — | $9,223.57 | $15,851 | $25,211 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 8 | — | — | $7,700.08 | $8,316.09 | $15,838 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 8 | — | — | $5,427.66 | $5,861.87 | $12,372 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 8 | — | — | $9,223.57 | $12,475 | $19,429 |
| COPD w MCC | MS-DRG | 190 | 8 | — | — | $8,379.22 | $9,049.56 | $13,109 |
| COPD w CC | MS-DRG | 191 | 8 | — | — | $6,533.53 | $7,056.21 | $11,582 |
| COPD w/o CC/MCC | MS-DRG | 192 | 8 | — | — | $5,132.02 | $5,542.58 | $9,247.79 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 8 | — | — | $6,274.87 | $6,776.86 | $10,972 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 8 | — | — | $5,037.89 | $5,440.92 | $9,223.57 |
| AMI discharged alive w MCC | MS-DRG | 280 | 8 | — | — | $9,223.57 | $12,787 | $19,681 |
| AMI discharged alive w CC | MS-DRG | 281 | 8 | — | — | $7,064.16 | $7,629.29 | $13,575 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 8 | — | — | $5,697.52 | $6,153.32 | $12,247 |
| Heart failure & shock w MCC | MS-DRG | 291 | 8 | — | — | $9,223.57 | $10,375 | $15,209 |
| Heart failure & shock w CC | MS-DRG | 292 | 8 | — | — | $6,575.39 | $7,101.42 | $10,379 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 8 | — | — | $4,602.1 | $4,970.27 | $9,283.7 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 8 | — | — | $9,050.69 | $9,774.3 | $14,114 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 8 | — | — | $5,785.36 | $6,248.19 | $9,223.57 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 8 | — | — | $4,602.79 | $4,971.01 | $9,223.57 |
| GI hemorrhage w CC | MS-DRG | 378 | 8 | — | — | $7,493.68 | $8,093.17 | $13,827 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 8 | — | — | $5,051.14 | $5,455.23 | $9,750.58 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 8 | — | — | $6,091.47 | $6,578.79 | $9,319.62 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 7 | — | — | $11,587 | $12,514 | $27,438 |
| Kidney/UTI w MCC | MS-DRG | 689 | 7 | — | — | $8,745.98 | $9,445.66 | $16,377 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 7 | — | — | $6,299.96 | $6,803.96 | $8,960.48 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 7 | — | — | $14,200 | $15,336 | $25,176 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 7 | — | — | $7,790.72 | $8,413.98 | $12,857 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 17 | $98 | $58.8 | $3.05 | $58.31 | $88.2 |
| Electrolyte panel | CPT | 80051 | 17 | $83 | $49.8 | $2.53 | $50.71 | $74.7 |
| Comprehensive metabolic panel | CPT | 80053 | 17 | $111 | $66.6 | $3.81 | $68.82 | $99.9 |
| Lipid panel | CPT | 80061 | 17 | $111 | $66.6 | $4.83 | $68.82 | $99.9 |
| Renal function panel | CPT | 80069 | 17 | $98 | $58.8 | $3.13 | $60.76 | $88.2 |
| Hepatic function panel | CPT | 80076 | 17 | $125 | $75 | $2.95 | $70 | $112.5 |
| Urinalysis non-automated | CPT | 81002 | 17 | $62 | $37.2 | $1.26 | $32.24 | $55.8 |
| Urinalysis automated | CPT | 81003 | 17 | $32 | $19.2 | $1.94 | $19.84 | $28.8 |
| Glucose quantitative | CPT | 82947 | 17 | $50 | $30 | $1.42 | $28 | $45 |
| Hemoglobin A1c | CPT | 83036 | 17 | $111 | $66.6 | $3.5 | $65.63 | $99.9 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 17 | $152 | $91.2 | $6.06 | $92.15 | $136.8 |
| Complete blood count with automated differential | CPT | 85025 | 17 | $83 | $49.8 | $2.8 | $48.38 | $74.7 |
| Complete blood count without differential | CPT | 85027 | 17 | $126 | $75.6 | $2.33 | $65.52 | $113.4 |
| Urine culture bacterial | CPT | 87086 | 17 | $98 | $58.8 | $2.91 | $53.24 | $88.2 |
| Urine culture identification | CPT | 87088 | 17 | $98 | $58.8 | $2.92 | $53.65 | $88.2 |
| Tissue exam by pathologist level IV | CPT | 88305 | 17 | $167 | $100.2 | $18.38 | $101.84 | $156.82 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 17 | $594 | $356.4 | $18.38 | $364.56 | $534.6 |
| Vaginal delivery only | CPT | 59409 | 16 | $17,332 | $10,399 | $822.32 | $10,746 | $15,599 |
| office | ||||||||
| Office visit, new patient, 15-29 min | CPT | 99202 | 17 | $360 | $216 | $36.08 | $226.26 | $324 |
| Office visit, new patient, 30-44 minutes | CPT | 99203 | 17 | $382 | $229.2 | $36.08 | $240.09 | $343.8 |
| Office visit, new patient, 45-59 min | CPT | 99204 | 17 | $479 | $287.4 | $36.08 | $301.05 | $431.1 |
| Office visit, new patient, 60-74 min | CPT | 99205 | 17 | $593 | $355.8 | $36.08 | $372.7 | $533.7 |
| Office visit, established patient, 5 min | CPT | 99211 | 17 | $139 | $83.4 | $21 | $87.36 | $125.1 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 17 | $174 | $104.4 | $27.3 | $109.36 | $156.6 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 17 | $202 | $121.2 | $36.08 | $126.96 | $181.8 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 17 | $237 | $142.2 | $36.08 | $148.96 | $213.3 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 17 | $294 | $176.4 | $36.08 | $187.48 | $264.6 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 17 | $2,024 | $1,214.4 | $131.48 | $1,254.88 | $1,861.98 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 17 | $2,761 | $1,656.6 | $156.01 | $1,711.82 | $2,493.18 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 17 | $997 | $598.2 | $55.81 | $651.54 | $1,143.02 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 17 | $5,504 | $3,302.4 | $66.85 | $2,862.08 | $4,953.6 |
| Colonoscopy diagnostic | CPT | 45378 | 17 | $2,500 | $1,500 | $189.53 | $1,550 | $2,493.18 |
| Colonoscopy with biopsy | CPT | 45380 | 17 | $2,761 | $1,656.6 | $236.69 | $1,711.82 | $2,493.18 |
| Colonoscopy with polyp removal | CPT | 45385 | 17 | $2,635 | $1,581 | $281.48 | $1,633.7 | $2,493.18 |
| surgery | ||||||||
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $9,223.57 | $9,223.57 | $9,223.57 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $9,223.57 | $9,223.57 | $9,223.57 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 10 | — | — | $570.67 | $2,264.96 | $3,522.02 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 8 | — | — | $9,223.57 | $35,320 | $51,716 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 8 | — | — | $9,223.57 | $18,759 | $31,802 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 8 | — | — | $9,223.57 | $13,381 | $23,901 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 8 | — | — | $9,223.57 | $13,446 | $22,913 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 8 | — | — | $9,223.57 | $10,993 | $19,052 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 8 | — | — | $9,223.57 | $26,364 | $60,012 |
| Laparoscopic appendectomy | CPT | 44970 | 8 | — | — | $1,067.82 | $5,573.36 | $6,007.35 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $9,223.57 | $9,223.57 | $9,223.57 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $9,223.57 | $9,223.57 | $9,223.57 |
| Major joint replacement w MCC | MS-DRG | 469 | 8 | — | — | $9,223.57 | $23,549 | $39,882 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 8 | — | — | $9,223.57 | $15,233 | $21,656 |
| Laparoscopic cholecystectomy | CPT | 47562 | 8 | — | — | $1,414.39 | $5,573.36 | $6,007.35 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 8 | — | — | $9,223.57 | $22,638 | $45,772 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 8 | — | — | $9,223.57 | $16,480 | $32,107 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 8 | — | — | $9,223.57 | $12,990 | $23,254 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 8 | — | — | $1,761.78 | $5,951.73 | $8,052.24 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 8 | — | — | $1,582.65 | $9,925.85 | $10,720 |
| Lap salpingo-oophorectomy | CPT | 58661 | 8 | — | — | $1,365.27 | $5,562.36 | $6,007.35 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 7 | — | — | $20,789 | $22,452 | $39,290 |
| OR procedure for obesity w CC | MS-DRG | 620 | 7 | — | — | $11,814 | $12,759 | $22,931 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 7 | — | — | $11,173 | $12,067 | $18,514 |
| Complex cataract surgery | CPT | 66982 | 8 | — | — | $784.52 | $2,326.61 | $4,934.09 |
| Cataract surgery with lens implant | CPT | 66984 | 10 | — | — | $632.66 | $2,207.02 | $5,156.09 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 7 | — | — | $9,306.58 | $10,051 | $15,676 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 7 | — | — | $14,841 | $16,137 | $18,298 |
Payer mix (top 17)
| Payer | Codes covered | Median rate |
|---|---|---|
| pa health & wellness | 150 | $247.36 |
| amerihealth caritas | 150 | $229.27 |
| Blue Cross Blue Shield | 150 | $485.02 |
| Cigna | 150 | $494 |
| Aetna | 150 | $379.84 |
| upmc health plan | 150 | $351 |
| UnitedHealthcare | 150 | $281.97 |
| upmc work partners | 140 | $731.58 |
| geisinger | 101 | $145.52 |
| intergroup | 99 | $839.48 |
| preferred healthcare system | 99 | $860.8 |
| private health care systems | 99 | $968.4 |
| selectcare | 99 | $968.4 |
| health coalition partners | 99 | $968.4 |
| First Health | 99 | $753.2 |
| Humana | 99 | $968.4 |
| health partners plans (jefferson health plan) | 90 | $156.16 |