healthcosts.net
Cath imag ivus pv 8.5fx90 .035 at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$7,522.20
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.
$12,537.00
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.
$597.63 with Highmark BCBS of PA vs $3,814.33 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 | $597.63 | ↓ -92% |
| Geisinger | Commercial | $1,359.79 | ↓ -82% |
| Aetna of PA | TPA/Carrier | $1,381.20 | ↓ -82% |
| United Healthcare | Commercial | $1,488.24 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,726.50 | ↓ -77% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,726.50 | ↓ -77% |
| Geisinger | Medicaid | $1,899.15 | ↓ -75% |
| Galaxy Health Plan | Commercial | $2,244.45 | ↓ -70% |
| UPMC Health Plan | Commercial | $2,284.65 | ↓ -70% |
| Humana | Commercial | $2,589.75 | ↓ -66% |
| UPMC Health Plan | CHIP | $3,814.33 | ↓ -49% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Cath imag ivus pv 8.5fx90 .035 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $3,611.40 | $23.25 – $3,011.96 |
| UPMC Muncy | Muncy | $1,237.80 | $16.20 – $97.20 |
| UPMC Passavant-McCandless | Pittsburgh | $5,895.00 | $20.50 – $5,535.07 |
| UPMC Presbyterian | Pittsburgh | $11,202.00 | $22.50 – $6,167.09 |
| UPMC St. Margaret | Pittsburgh | $3,339.60 | $23.00 – $4,680.45 |
| UPMC Williamsport | Williamsport | $3,262.80 | $29.16 – $1,087.60 |