Autologous blood process at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$201.60
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.
$336.00
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.
$85.45 with Geisinger vs $306.68 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Geisinger | Commercial | $85.45 | ↓ -58% |
| Aetna of PA | TPA/Carrier | $86.80 | ↓ -57% |
| Highmark BCBS of PA | Medicare Advantage | $87.16 | ↓ -57% |
| United Healthcare | Commercial | $93.53 | ↓ -54% |
| Multiplan | PPO (Includes PHCS as a Payer) | $108.50 | ↓ -46% |
| United Healthcare Community Plan for Families | PA Medicaid | $110.31 | ↓ -45% |
| Geisinger | Medicaid | $119.35 | ↓ -41% |
| Galaxy Health Plan | Commercial | $141.05 | ↓ -30% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $161.74 | ↓ -20% |
| Humana | Commercial | $162.75 | ↓ -19% |
| UPMC Health Plan | Managed Medicare | $163.37 | ↓ -19% |
| United Healthcare | Medicare | $163.37 | ↓ -19% |
| AmeriHealth Caritas | Medicare | $163.37 | ↓ -19% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $166.64 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $176.42 | ↓ -12% |
| UPMC Health Plan | Commercial | $182.83 | ↓ -9% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $242.29 | ↑ +20% |
| UPMC Health Plan | CHIP | $265.05 | ↑ +31% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $306.68 | ↑ +52% |
| Tricare | East Region | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Autologous blood process at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $201.60 | $46.03 – $285.60 |
| UPMC Community Osteopathic | Harrisburg | $201.60 | $43.40 – $265.05 |
| UPMC East | Monroeville | $680.40 | $72.91 – $907.20 |
| UPMC Hanover | Hanover | $201.60 | $125.66 – $265.05 |
| UPMC Horizon-Greenville | Greenville | $253.80 | $73.83 – $176.44 |
| UPMC Jameson | New Castle | $253.80 | $7.44 – $176.44 |
| UPMC Lititz | Lititz | $201.60 | $125.66 – $265.05 |
| UPMC Magee | Pittsburgh | $301.20 | $77.15 – $179.71 |