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Bln 30frx10mmx12cm renal nephromax at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$661.80
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.
$1,103.00
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.
$369.78 with Geisinger vs $1,269.13 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 |
|---|---|---|---|
| Geisinger | Commercial | $369.78 | ↓ -44% |
| Aetna of PA | TPA/Carrier | $375.60 | ↓ -43% |
| United Healthcare | Commercial | $404.71 | ↓ -39% |
| Highmark BCBS of PA | Medicare Advantage | $464.81 | ↓ -30% |
| Highmark Wholecare (prev Gateway) | Medicare | $469.50 | ↓ -29% |
| Multiplan | PPO (Includes PHCS as a Payer) | $469.50 | ↓ -29% |
| Geisinger | Medicaid | $516.45 | ↓ -22% |
| Galaxy Health Plan | Commercial | $610.35 | ↓ -8% |
| Humana | Commercial | $704.25 | ↑ +6% |
| UPMC Health Plan | Commercial | $760.16 | ↑ +15% |
| UPMC Health Plan | CHIP | $1,269.13 | ↑ +92% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Bln 30frx10mmx12cm renal nephromax at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $5,428.20 | $57.50 – $1,002.16 |
| UPMC Muncy | Muncy | $4,790.40 | $52.95 – $317.70 |
| UPMC Northwest | Seneca | $752.40 | $182.25 – $1,535.76 |
| UPMC Passavant-McCandless | Pittsburgh | $1,429.80 | $65.25 – $1,841.66 |
| UPMC Presbyterian | Pittsburgh | $6,414.60 | $48.42 – $2,051.95 |
| UPMC St. Margaret | Pittsburgh | $3,997.20 | $61.50 – $1,557.31 |
| UPMC Wellsboro | Wellsboro | $5,793.60 | $39.06 – $195.30 |
| UPMC Williamsport | Williamsport | $4,790.40 | $19.00 – $85.50 |