Aep neurodiagnostic i&r at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$583.80
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.
$973.00
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.
$62.36 with Highmark BCBS of PA vs $729.75 with Humana — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare Advantage | $62.36 | ↓ -89% |
| UPMC Health Plan | Managed Medicaid | $74.26 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $77.50 | ↓ -87% |
| United Healthcare Community Plan for Families | PA Medicaid | $77.64 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $86.62 | ↓ -85% |
| Geisinger | Medicaid | $93.83 | ↓ -84% |
| UPMC Work Partners | Workers Comp | $97.73 | ↓ -83% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $293.91 | ↓ -50% |
| UPMC Health Plan | Managed Medicare | $296.88 | ↓ -49% |
| AmeriHealth Caritas | Medicare | $296.88 | ↓ -49% |
| United Healthcare | Medicare | $296.88 | ↓ -49% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $302.82 | ↓ -48% |
| Highmark Wholecare (prev Gateway) | Medicare | $320.60 | ↓ -45% |
| UPMC Health Plan | CHIP | $340.55 | ↓ -42% |
| Geisinger | Commercial | $383.17 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $389.20 | ↓ -33% |
| United Healthcare | Commercial | $419.36 | ↓ -28% |
| UPMC Health Plan | Commercial | $437.85 | ↓ -25% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $440.30 | ↓ -25% |
| Multiplan | PPO (Includes PHCS as a Payer) | $486.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $557.30 | ↓ -5% |
| Galaxy Health Plan | Commercial | $632.45 | ↑ +8% |
| Humana | Commercial | $729.75 | ↑ +25% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Aep neurodiagnostic i&r at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $261.00 | $62.99 – $348.00 |
| UPMC Carlisle | Carlisle | $583.80 | $85.74 – $827.05 |
| UPMC Community Osteopathic | Harrisburg | $583.80 | $85.74 – $827.05 |
| UPMC Hamot | Erie | $898.20 | $62.99 – $395.44 |
| UPMC Hanover | Hanover | $583.80 | $85.74 – $475.97 |
| UPMC Jameson | New Castle | $1,593.60 | $64.11 – $371.10 |
| UPMC Lititz | Lititz | $583.80 | $85.74 – $478.54 |
| UPMC Magee | Pittsburgh | $831.60 | $63.59 – $320.63 |