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Cath hawkone s directional at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$7,639.20
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.
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What you pay up front if you don't use insurance.
$12,732.00
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.
$427.62 with Highmark BCBS of PA vs $7,653.02 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 BCBS of PA | Medicare Advantage | $427.62 | ↓ -94% |
| Geisinger | Commercial | $2,748.33 | ↓ -64% |
| Aetna of PA | TPA/Carrier | $2,791.60 | ↓ -63% |
| United Healthcare | Commercial | $3,007.95 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,489.50 | ↓ -54% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,489.50 | ↓ -54% |
| Geisinger | Medicaid | $3,838.45 | ↓ -50% |
| Galaxy Health Plan | Commercial | $4,536.35 | ↓ -41% |
| UPMC Health Plan | Commercial | $4,583.88 | ↓ -40% |
| Humana | Commercial | $5,234.25 | ↓ -31% |
| UPMC Health Plan | CHIP | $7,653.02 | ↑ +0% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Cath hawkone s directional at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $7,680.60 | $431.99 – $8,478.00 |
| UPMC Northwest | Seneca | $7,936.80 | $1,121.17 – $11,243.80 |
| UPMC Passavant-McCandless | Pittsburgh | $5,620.20 | $436.10 – $11,105.48 |
| UPMC Presbyterian | Pittsburgh | $11,569.20 | $436.10 – $12,373.56 |
| UPMC St. Margaret | Pittsburgh | $7,996.80 | $436.10 – $9,390.80 |
| UPMC Williamsport | Williamsport | $14,437.80 | $6,497.01 – $21,656.70 |