healthcosts.net
Cath 2lum 14.5frx43cm maxid kt mahurkar at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$364.20
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.
?
What you pay up front if you don't use insurance.
$607.00
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.
$63.80 with Geisinger vs $968.69 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 | $63.80 | ↓ -82% |
| Aetna of PA | TPA/Carrier | $64.80 | ↓ -82% |
| United Healthcare | Commercial | $69.82 | ↓ -81% |
| Highmark BCBS of PA | Medicare Advantage | $80.19 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $81.00 | ↓ -78% |
| Multiplan | PPO (Includes PHCS as a Payer) | $81.00 | ↓ -78% |
| Geisinger | Medicaid | $89.10 | ↓ -76% |
| Highmark Wholecare (prev Gateway) | Medicaid | $104.00 | ↓ -71% |
| Galaxy Health Plan | Commercial | $105.30 | ↓ -71% |
| Humana | Commercial | $121.50 | ↓ -67% |
| UPMC Health Plan | Commercial | $580.21 | ↑ +59% |
| UPMC Health Plan | CHIP | $968.69 | ↑ +166% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Cath 2lum 14.5frx43cm maxid kt mahurkar at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $1,345.80 | $96.96 – $764.92 |
| UPMC Northwest | Seneca | $428.40 | $178.50 – $1,172.20 |
| UPMC Passavant-McCandless | Pittsburgh | $1,062.60 | $52.25 – $1,405.69 |
| UPMC Presbyterian | Pittsburgh | $1,950.00 | $37.44 – $1,566.20 |
| UPMC St. Margaret | Pittsburgh | $973.80 | $41.25 – $1,188.65 |
| UPMC Wellsboro | Wellsboro | $454.40 | $102.24 – $511.20 |
| UPMC Williamsport | Williamsport | $403.80 | $118.80 – $396.00 |