healthcosts.net
Chg radiologic exam esophagus double contrast at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$427.80
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.
$713.00
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.
$38.79 with Highmark BCBS of PA vs $318.60 with Highmark BCBS of PA — 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 | $38.79 | ↓ -91% |
| Geisinger | Commercial | $48.83 | ↓ -89% |
| Aetna of PA | TPA/Carrier | $49.60 | ↓ -88% |
| United Healthcare | Commercial | $53.44 | ↓ -88% |
| Multiplan | PPO (Includes PHCS as a Payer) | $62.00 | ↓ -86% |
| United Healthcare Community Plan for Families | PA Medicaid | $64.41 | ↓ -85% |
| Galaxy Health Plan | Commercial | $80.60 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $92.49 | ↓ -78% |
| Humana | Commercial | $93.00 | ↓ -78% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $96.52 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $107.87 | ↓ -75% |
| Geisinger | Medicaid | $116.86 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $127.09 | ↓ -70% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $168.02 | ↓ -61% |
| AmeriHealth Caritas | Medicare | $169.72 | ↓ -60% |
| UPMC Health Plan | Managed Medicare | $169.72 | ↓ -60% |
| United Healthcare | Medicare | $169.72 | ↓ -60% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $173.11 | ↓ -60% |
| Highmark Wholecare (prev Gateway) | Medicare | $183.28 | ↓ -57% |
| UPMC Health Plan | Commercial | $203.66 | ↓ -52% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $251.71 | ↓ -41% |
| UPMC Health Plan | CHIP | $270.76 | ↓ -37% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $318.60 | ↓ -26% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Chg radiologic exam esophagus double contrast at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $804.00 | $39.56 – $1,139.00 |
| UPMC Muncy | Muncy | $713.40 | $71.69 – $951.20 |
| UPMC Northwest | Seneca | $253.20 | $92.49 – $358.70 |
| UPMC Presbyterian | Pittsburgh | $1,312.80 | $39.56 – $1,859.80 |
| UPMC St. Margaret | Pittsburgh | $779.40 | $39.56 – $1,104.15 |
| UPMC Wellsboro | Wellsboro | $862.40 | $71.69 – $970.20 |
| UPMC Williamsport | Williamsport | $712.20 | $71.69 – $949.60 |