healthcosts.net
Cath ablt clsfast 7fx100cmx at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$2,271.00
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.
?
What you pay up front if you don't use insurance.
$3,785.00
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.
$635.96 with Highmark BCBS of PA vs $4,098.86 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare Advantage | $635.96 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicaid | $757.00 | ↓ -67% |
| Geisinger | Medicaid | $1,249.05 | ↓ -45% |
| Geisinger | Commercial | $1,490.53 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $1,514.00 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,892.50 | ↓ -17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,892.50 | ↓ -17% |
| UPMC Health Plan | Commercial | $2,455.07 | ↑ +8% |
| Galaxy Health Plan | Commercial | $2,460.25 | ↑ +8% |
| Humana | Commercial | $2,838.75 | ↑ +25% |
| UPMC Health Plan | CHIP | $4,098.86 | ↑ +80% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Cath ablt clsfast 7fx100cmx at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $6,990.00 | $250.50 – $3,236.64 |
| UPMC Muncy | Muncy | $3,024.00 | $756.00 – $4,536.00 |
| UPMC Northwest | Seneca | $1,363.20 | $477.00 – $4,959.99 |
| UPMC Passavant-McCandless | Pittsburgh | $5,457.00 | $638.00 – $5,947.96 |
| UPMC Presbyterian | Pittsburgh | $8,981.40 | $648.57 – $6,627.13 |
| UPMC St. Margaret | Pittsburgh | $8,284.20 | $572.75 – $5,029.60 |
| UPMC Wellsboro | Wellsboro | $3,656.80 | $822.78 – $4,113.90 |
| UPMC Williamsport | Williamsport | $3,024.00 | $620.19 – $2,067.30 |