healthcosts.net
Bln 1.2 mono emrg 15x1.2 at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$6,126.60
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.
$10,211.00
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.
$110.66 with Geisinger vs $1,274.39 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 |
|---|---|---|---|
| Geisinger | Commercial | $110.66 | ↓ -98% |
| Aetna of PA | TPA/Carrier | $112.40 | ↓ -98% |
| United Healthcare | Commercial | $121.11 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicare | $140.50 | ↓ -98% |
| Multiplan | PPO (Includes PHCS as a Payer) | $140.50 | ↓ -98% |
| Geisinger | Medicaid | $154.55 | ↓ -97% |
| Galaxy Health Plan | Commercial | $182.65 | ↓ -97% |
| Humana | Commercial | $210.75 | ↓ -97% |
| Highmark BCBS of PA | Medicare Advantage | $336.94 | ↓ -95% |
| UPMC Health Plan | Commercial | $763.32 | ↓ -88% |
| UPMC Health Plan | CHIP | $1,274.39 | ↓ -79% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Bln 1.2 mono emrg 15x1.2 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $8,967.60 | $41.75 – $1,006.31 |
| UPMC Muncy | Muncy | $805.80 | $63.90 – $383.40 |
| UPMC Northwest | Seneca | $3,042.60 | $66.00 – $1,542.13 |
| UPMC Passavant-McCandless | Pittsburgh | $9,111.60 | $51.75 – $1,849.30 |
| UPMC Presbyterian | Pittsburgh | $15,157.20 | $9.18 – $2,060.46 |
| UPMC St. Margaret | Pittsburgh | $6,582.60 | $102.00 – $1,563.77 |
| UPMC Wellsboro | Wellsboro | $5,457.60 | $69.66 – $348.30 |
| UPMC Williamsport | Williamsport | $3,807.00 | $75.87 – $252.90 |