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#a/b/c/c/h pnl-candida albicans ab at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$66.60
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.
$111.00
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.
$11.87 with UPMC Work Partners vs $104.22 with UPMC Health Plan — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $11.87 | ↓ -82% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $11.89 | ↓ -82% |
| AmeriHealth Caritas | Medicare | $12.01 | ↓ -82% |
| UPMC Health Plan | Managed Medicare | $12.01 | ↓ -82% |
| United Healthcare | Medicare | $12.01 | ↓ -82% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $12.25 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.97 | ↓ -81% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $17.81 | ↓ -73% |
| UPMC Health Plan | Managed Medicaid | $18.26 | ↓ -73% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $19.06 | ↓ -71% |
| United Healthcare Community Plan for Families | PA Medicaid | $19.09 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicaid | $21.30 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $22.55 | ↓ -66% |
| Geisinger | Medicaid | $23.07 | ↓ -65% |
| Highmark BCBS of PA | Medicare Advantage | $33.32 | ↓ -50% |
| United Healthcare | Commercial | $38.74 | ↓ -42% |
| Geisinger | Commercial | $43.71 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $44.40 | ↓ -33% |
| Multiplan | PPO (Includes PHCS as a Payer) | $55.50 | ↓ -17% |
| UPMC Health Plan | Commercial | $71.89 | ↑ +8% |
| Galaxy Health Plan | Commercial | $72.15 | ↑ +8% |
| Humana | Commercial | $83.25 | ↑ +25% |
| UPMC Health Plan | CHIP | $104.22 | ↑ +56% |
Visitor-reported prices
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#a/b/c/c/h pnl-candida albicans ab at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $282.60 | $11.16 – $400.35 |
| UPMC Mercy | Pittsburgh | $133.20 | $10.01 – $199.80 |
| UPMC Northwest | Seneca | $112.80 | $10.89 – $159.80 |
| UPMC Presbyterian | Pittsburgh | $268.80 | $11.87 – $380.80 |
| UPMC St. Margaret | Pittsburgh | $201.00 | $10.37 – $284.75 |
| UPMC Wellsboro | Wellsboro | $140.00 | $11.87 – $157.50 |
| UPMC Williamsport | Williamsport | $115.80 | $11.87 – $154.40 |