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Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$5,022.00
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.
$8,370.00
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.
$141.00 with Highmark Wholecare (prev Gateway) vs $1,323.84 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $141.00 | ↓ -97% |
| Geisinger | Medicaid | $232.65 | ↓ -95% |
| Geisinger | Commercial | $277.63 | ↓ -94% |
| Aetna of PA | TPA/Carrier | $282.00 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $352.50 | ↓ -93% |
| Multiplan | PPO (Includes PHCS as a Payer) | $352.50 | ↓ -93% |
| Galaxy Health Plan | Commercial | $458.25 | ↓ -91% |
| Humana | Commercial | $528.75 | ↓ -89% |
| Highmark BCBS of PA | Medicare Advantage | $638.30 | ↓ -87% |
| UPMC Health Plan | Commercial | $792.93 | ↓ -84% |
| UPMC Health Plan | CHIP | $1,323.84 | ↓ -74% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Bln stent lg 19mm diam 10-12mm palmaz gen trnshpat unmtd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $6,811.80 | $34.80 – $1,045.36 |
| UPMC Northwest | Seneca | $2,530.20 | $1,054.25 – $3,584.45 |
| UPMC Passavant-McCandless | Pittsburgh | $5,142.60 | $650.96 – $5,643.15 |
| UPMC Presbyterian | Pittsburgh | $15,638.40 | $24.24 – $2,140.41 |
| UPMC St. Margaret | Pittsburgh | $11,917.80 | $650.96 – $5,979.75 |
| UPMC Williamsport | Williamsport | $1,989.60 | $663.20 – $2,984.40 |