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 Altoona | Altoona | $2,126.40 | $42.50 – $3,814.33 |
| UPMC Community Osteopathic | Harrisburg | $7,522.20 | $690.60 – $3,814.33 |
| UPMC East | Monroeville | $6,164.40 | $14.50 – $3,814.33 |
| UPMC Hamot | Erie | $5,631.00 | $603.74 – $603.74 |
| UPMC Magee | Pittsburgh | $2,281.20 | $94.53 – $3,814.33 |
| UPMC McKeesport | Mckeesport | $2,257.80 | $94.53 – $3,814.33 |
| UPMC Memorial | York | $7,522.20 | $85.94 – $3,814.33 |
| UPMC Mercy | Pittsburgh | $3,611.40 | $603.74 – $3,011.96 |