healthcosts.net
Bilirubin total at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$25.20
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.
$42.00
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.
$4.96 with UPMC Work Partners vs $45.19 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 | $4.96 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $4.97 | ↓ -80% |
| AmeriHealth Caritas | Medicare | $5.02 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $5.02 | ↓ -80% |
| United Healthcare | Medicare | $5.02 | ↓ -80% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $5.12 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicare | $5.42 | ↓ -78% |
| CBHNP | Commercial | $6.93 | ↓ -73% |
| CCBHN | Commercial | $6.93 | ↓ -73% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $7.45 | ↓ -70% |
| UPMC Health Plan | Managed Medicaid | $7.62 | ↓ -70% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $7.96 | ↓ -68% |
| United Healthcare Community Plan for Families | PA Medicaid | $7.97 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicaid | $8.89 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $9.42 | ↓ -63% |
| Geisinger | Medicaid | $9.63 | ↓ -62% |
| United Healthcare | Commercial | $12.21 | ↓ -52% |
| Highmark BCBS of PA | Medicare Advantage | $13.19 | ↓ -48% |
| Geisinger | Commercial | $13.78 | ↓ -45% |
| Aetna of PA | TPA/Carrier | $14.00 | ↓ -44% |
| Multiplan | PPO (Includes PHCS as a Payer) | $17.50 | ↓ -31% |
| Galaxy Health Plan | Commercial | $22.75 | ↓ -10% |
| Humana | Commercial | $26.25 | ↑ +4% |
| UPMC Health Plan | Commercial | $31.17 | ↑ +24% |
| UPMC Health Plan | CHIP | $45.19 | ↑ +79% |
Visitor-reported prices
Comments
Bilirubin total at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $126.60 | $4.67 – $179.35 |
| UPMC Mercy | Pittsburgh | $58.80 | $4.18 – $88.20 |
| UPMC Muncy | Muncy | $133.80 | $4.96 – $101.60 |
| UPMC Northwest | Seneca | $33.00 | $4.55 – $46.75 |
| UPMC Presbyterian | Pittsburgh | $231.60 | $4.96 – $328.10 |
| UPMC St. Margaret | Pittsburgh | $66.60 | $4.33 – $94.35 |
| UPMC Wellsboro | Wellsboro | $161.60 | $4.96 – $102.60 |
| UPMC Williamsport | Williamsport | $75.60 | $4.96 – $100.80 |