Anterior thoracic extension at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$496.80
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.
$828.00
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.
$165.60 with Highmark Wholecare (prev Gateway) vs $1,127.45 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $165.60 | ↓ -67% |
| United Healthcare Community Plan for Families | PA Medicaid | $172.50 | ↓ -65% |
| Geisinger | Medicaid | $273.24 | ↓ -45% |
| Highmark BCBS of PA | Medicare Advantage | $299.70 | ↓ -40% |
| Geisinger | Commercial | $326.07 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $331.20 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $414.00 | ↓ -17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $414.00 | ↓ -17% |
| UPMC Work Partners | Workers Comp | $432.21 | ↓ -13% |
| Galaxy Health Plan | Commercial | $538.20 | ↑ +8% |
| Humana | Commercial | $621.00 | ↑ +25% |
| UPMC Health Plan | Commercial | $675.30 | ↑ +36% |
| UPMC Health Plan | CHIP | $1,127.45 | ↑ +127% |
Visitor-reported prices
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Anterior thoracic extension at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $496.80 | $113.44 – $703.80 |
| UPMC Community Osteopathic | Harrisburg | $496.80 | $165.60 – $1,593.67 |
| UPMC Hanover | Hanover | $496.80 | $196.50 – $1,127.45 |
| UPMC Lititz | Lititz | $496.80 | $135.62 – $1,127.45 |
| UPMC Memorial | York | $496.80 | $135.62 – $1,127.45 |