healthcosts.net
Collection blood specimen using established central/peripheral catheter venous nos at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$537.00
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.
$895.00
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.
$38.42 with UPMC Work Partners vs $230.69 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $38.42 | ↓ -93% |
| Highmark BCBS of PA | Medicare Advantage | $43.57 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $81.45 | ↓ -85% |
| UPMC Health Plan | Commercial | $82.78 | ↓ -85% |
| Geisinger | Commercial | $110.26 | ↓ -79% |
| Aetna of PA | TPA/Carrier | $112.00 | ↓ -79% |
| United Healthcare | Commercial | $120.68 | ↓ -78% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $121.66 | ↓ -77% |
| AmeriHealth Caritas | Medicare | $122.89 | ↓ -77% |
| UPMC Health Plan | Managed Medicare | $122.89 | ↓ -77% |
| United Healthcare | Medicare | $122.89 | ↓ -77% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $125.35 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicare | $132.71 | ↓ -75% |
| UPMC Health Plan | CHIP | $138.21 | ↓ -74% |
| Multiplan | PPO (Includes PHCS as a Payer) | $140.00 | ↓ -74% |
| Geisinger | Medicaid | $154.00 | ↓ -71% |
| Galaxy Health Plan | Commercial | $182.00 | ↓ -66% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $182.26 | ↓ -66% |
| Humana | Commercial | $210.00 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $230.69 | ↓ -57% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Collection blood specimen using established central/peripheral catheter venous nos at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $243.00 | $38.42 – $325.55 |
| UPMC Mercy | Pittsburgh | $125.40 | $44.02 – $188.10 |
| UPMC Muncy | Muncy | $162.00 | $38.42 – $216.00 |
| UPMC Northwest | Seneca | $240.00 | $38.42 – $340.00 |
| UPMC Presbyterian | Pittsburgh | $218.40 | $44.44 – $309.40 |
| UPMC St. Margaret | Pittsburgh | $88.20 | $37.04 – $132.71 |
| UPMC Wellsboro | Wellsboro | $196.00 | $38.42 – $220.50 |
| UPMC Williamsport | Williamsport | $162.00 | $38.42 – $216.00 |