healthcosts.net
Bacterial meningitis antigen at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$42.60
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.
?
What you pay up front if you don't use insurance.
$71.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$11.40 with UPMC Work Partners vs $63.78 with UPMC Health Plan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $11.40 | ↓ -73% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $11.42 | ↓ -73% |
| AmeriHealth Caritas | Medicare | $11.54 | ↓ -73% |
| UPMC Health Plan | Managed Medicare | $11.54 | ↓ -73% |
| United Healthcare | Medicare | $11.54 | ↓ -73% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11.77 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.46 | ↓ -71% |
| UPMC Health Plan | Managed Medicaid | $15.49 | ↓ -64% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $16.16 | ↓ -62% |
| United Healthcare Community Plan for Families | PA Medicaid | $16.19 | ↓ -62% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $17.11 | ↓ -60% |
| Highmark Wholecare (prev Gateway) | Medicaid | $18.06 | ↓ -58% |
| Highmark BCBS of PA | Medicare Advantage | $19.49 | ↓ -54% |
| Geisinger | Medicaid | $19.57 | ↓ -54% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $21.66 | ↓ -49% |
| United Healthcare | Commercial | $24.78 | ↓ -42% |
| Geisinger | Commercial | $27.96 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $28.40 | ↓ -33% |
| Multiplan | PPO (Includes PHCS as a Payer) | $35.50 | ↓ -17% |
| UPMC Health Plan | Commercial | $44.00 | ↑ +3% |
| Galaxy Health Plan | Commercial | $46.15 | ↑ +8% |
| Humana | Commercial | $53.25 | ↑ +25% |
| UPMC Health Plan | CHIP | $63.78 | ↑ +50% |
Visitor-reported prices
Comments
Bacterial meningitis antigen at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $201.60 | $10.72 – $285.60 |
| UPMC Mercy | Pittsburgh | $108.00 | $9.62 – $162.00 |
| UPMC Northwest | Seneca | $236.40 | $10.47 – $334.90 |
| UPMC Presbyterian | Pittsburgh | $316.20 | $11.40 – $447.95 |
| UPMC St. Margaret | Pittsburgh | $240.00 | $9.96 – $340.00 |
| UPMC Wellsboro | Wellsboro | $121.60 | $11.40 – $136.80 |
| UPMC Williamsport | Williamsport | $100.80 | $11.40 – $134.40 |